Division of Vascular Surgery, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Ore 97239-3098, USA.
J Vasc Surg. 2013 Jun;57(6):1710-6. doi: 10.1016/j.jvs.2013.03.012. Epub 2013 Apr 23.
Raynaud's syndrome (RS) is characterized by episodic digital ischemia induced by cold or emotional stress. Pathophysiologic mechanisms include temporary vasospasm and fixed digital artery obstruction. A number of pharmacologic and invasive therapies have been studied to treat RS symptoms; however, there are no specific treatments that are currently approved by the U.S. Food and Drug Administration specifically for RS. Of the available pharmacologic agents, calcium-channel blockers remain the preferred initial treatment for vasospastic RS, although many vasodilators have been studied and found to be efficacious. Vasodilators are less effective in treating digital artery obstruction, and no treatments have been found to be universally beneficial, although the phosphodiesterase V inhibitors have been gaining in popularity. Invasive therapies may have a role in selective cases. In this review, the current evidence of treatment for RS is summarized.
雷诺氏综合征(RS)的特征是由寒冷或情绪压力引起的阵发性手指缺血。病理生理机制包括暂时性血管痉挛和固定的手指动脉阻塞。已经研究了许多药物和介入治疗方法来治疗 RS 症状;然而,目前还没有美国食品和药物管理局专门批准的针对 RS 的特定治疗方法。在现有的药物中,钙通道阻滞剂仍然是治疗血管痉挛性 RS 的首选初始治疗方法,尽管已经研究了许多血管扩张剂并发现它们有效。血管扩张剂在治疗手指动脉阻塞方面效果较差,而且没有发现任何治疗方法普遍有效,尽管磷酸二酯酶 V 抑制剂越来越受欢迎。在某些选择性病例中,介入治疗可能有一定作用。在这篇综述中,总结了目前 RS 治疗的证据。