Oliver G F, Winkelmann R K
Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
Drugs. 1989 Jan;37(1):87-96. doi: 10.2165/00003495-198937010-00006.
The treatment of scleroderma is determined by the stage of the disease, associated organ involvement, or the presence of features overlapping those of other connective tissue disease. Raynaud's phenomenon is responsive to vasoactive medication, but recently heat and plasma exchange have been shown to be more effective, reducing the need for systemic medication. In stages II and III of the disease, administration of non-toxic penicillamine in low doses for 2 to 4 years is the preferred treatment. Plasma exchange may offer some hope in the early stages. The treatment of the renal crisis of scleroderma with angiotensin-converting enzyme inhibitors has reduced mortality from this complication. These drugs are currently the preferred treatment for the hypertension of renal scleroderma. The symptomatic treatment of the pulmonary, gastrointestinal, and soft tissue complications of scleroderma is also discussed.
硬皮病的治疗取决于疾病阶段、相关器官受累情况或是否存在与其他结缔组织病重叠的特征。雷诺现象对血管活性药物有反应，但最近研究表明，热疗和血浆置换更有效，可减少全身用药的需求。在疾病的II期和III期，低剂量服用无毒青霉胺2至4年是首选治疗方法。血浆置换在疾病早期可能带来一些希望。用血管紧张素转换酶抑制剂治疗硬皮病肾危象已降低了该并发症的死亡率。这些药物目前是肾性硬皮病高血压的首选治疗药物。本文还讨论了硬皮病肺部、胃肠道和软组织并发症的对症治疗。
