Herrick Ariane
Rheumatic Diseases Centre, University of Manchester, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK.
Rheum Dis Clin North Am. 2008 Feb;34(1):89-114; vii. doi: 10.1016/j.rdc.2007.11.006.
The manifestations of peripheral vascular disease in patients who have systemic sclerosis (SSc) range from episodic Raynaud's phenomenon to irreversible tissue injury with ulceration and gangrene. Structural and functional changes may occur in the microvessels, digital arteries, and sometimes more proximal vessels. This article discusses the assessment of patients who have Raynaud's phenomenon in whom an underlying scleroderma-spectrum disorder is suspected and patients who have SSc with critical digital ischemia/ulceration. Different imaging techniques, including capillaroscopy and angiography, complement the history and examination, and developments in vascular imaging should facilitate future studies of pathogenesis and treatment response. New vasoactive treatments are currently being researched and older treatments revisited; therefore new approaches to therapy will likely be developed over the next 5 to 10 years.
系统性硬化症（SSc）患者的外周血管疾病表现多样，从发作性雷诺现象到伴有溃疡和坏疽的不可逆组织损伤。微血管、指动脉，有时更靠近心脏的血管可能会出现结构和功能变化。本文讨论了疑似潜在硬皮病谱系障碍的雷诺现象患者以及患有严重指端缺血/溃疡的SSc患者的评估。不同的成像技术，包括毛细血管镜检查和血管造影，可辅助病史采集和体格检查，血管成像技术的发展应有助于未来对发病机制和治疗反应的研究。目前正在研究新的血管活性治疗方法，并重新审视旧的治疗方法；因此，未来5至10年内可能会开发出新的治疗方法。
