Department of Internal Medicine, Rheumatology Clinic, Medical School, University of Ioannina, 45110 Ioannina, Greece.
Joint Bone Spine. 2011 Jul;78(4):341-6. doi: 10.1016/j.jbspin.2010.11.005. Epub 2010 Dec 22.
Raynaud's phenomenon (RP) and digital ulcers (DU) are the clinical manifestations of vasculopathy in systemic sclerosis. Both interfere with hand function and hold the possibility of severe complications, thus adversely influencing patients' quality of life. Managing RP and DU is often a challenge for the treating physician, who has to establish a treatment plan based upon knowledge of the current therapeutic options. The first step is to differentiate primary from secondary RP, where combining history and physical examination with diagnostic modalities, such as nailfold capillaroscopy, aids in reaching the correct diagnosis. Next a wide range of treatment options is offered nowadays, starting from first-line agents, as calcium channel blockers, to the more targeted-ones, like endothelin receptor antagonists. Research and clinical experience with each agent are reviewed in the text, as well as the combinations that more recently gain field in the treatment of DU.
雷诺现象（RP）和指溃疡（DU）是系统性硬化症血管病变的临床表现。两者均会影响手部功能，并有可能导致严重并发症，从而对患者的生活质量产生不利影响。管理 RP 和 DU 常常是治疗医生面临的挑战，他们必须根据当前治疗选择的知识制定治疗计划。第一步是区分原发性和继发性 RP，通过病史和体格检查以及指甲皱襞毛细血管镜等诊断方法来做出正确诊断。接下来，目前提供了广泛的治疗选择，从一线药物，如钙通道阻滞剂，到更具针对性的药物，如内皮素受体拮抗剂。本文回顾了每种药物的研究和临床经验，以及最近在 DU 治疗中广泛应用的联合治疗方案。
