雷诺现象的循证管理
Evidence-based management of Raynaud's phenomenon.
作者信息
Herrick Ariane L
机构信息
Centre for Musculoskeletal Research, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester UK, M13 9PT and NIHR Manchester Biomedical Research Centre, Central Manchester NHS Foundation Trust, Manchester, UK.
出版信息
Ther Adv Musculoskelet Dis. 2017 Dec;9(12):317-329. doi: 10.1177/1759720X17740074. Epub 2017 Nov 20.
Abstract
Raynaud's phenomenon (RP) is relevant to the rheumatologist because it may signify an underlying connective tissue disease and also because it can be very challenging to treat, especially when it has progressed to digital ulceration or critical ischaemia. This review article discusses diagnosis (does this patient have an underlying connective tissue disease?), including the role for nailfold capillaroscopy, and treatment. Management of 'uncomplicated' RP is first described and then treatment of RP complicated by progression to digital ulceration or critical ischaemia, highlighting recent advances (including phosphodiesterase type 5 inhibition, and endothelin 1 receptor antagonism) and the evidence base underpinning these. Possible future therapies are briefly discussed.
摘要
雷诺现象（RP）与风湿病学家密切相关，因为它可能预示着潜在的结缔组织疾病，而且治疗起来可能极具挑战性，尤其是当病情发展到手指溃疡或严重缺血时。这篇综述文章讨论了诊断（该患者是否患有潜在的结缔组织疾病？），包括甲襞毛细血管镜检查的作用，以及治疗方法。首先描述了“单纯性”RP的管理，然后是发展为手指溃疡或严重缺血的复杂性RP的治疗，重点介绍了最新进展（包括5型磷酸二酯酶抑制和内皮素1受体拮抗）及其背后的证据基础。还简要讨论了可能的未来治疗方法。
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本文引用的文献
1
Efficacy and Safety of Selexipag in Adults With Raynaud's Phenomenon Secondary to Systemic Sclerosis: A Randomized, Placebo-Controlled, Phase II Study.塞来昔帕用于治疗系统性硬化症相关雷诺现象的成人患者的疗效和安全性：一项随机、安慰剂对照、II 期研究。
Arthritis Rheumatol. 2017 Dec;69(12):2370-2379. doi: 10.1002/art.40242.
2
Reduced perfusion in systemic sclerosis digital ulcers (both fingertip and extensor) can be increased by topical application of glyceryl trinitrate.通过局部应用硝酸甘油可增加系统性硬化症指端溃疡（包括指尖和伸侧）的灌注不足情况。
Microvasc Res. 2017 May;111:32-36. doi: 10.1016/j.mvr.2016.12.008. Epub 2016 Dec 24.
3
Update of EULAR recommendations for the treatment of systemic sclerosis.EULAR 系统性硬皮病治疗推荐更新。
Ann Rheum Dis. 2017 Aug;76(8):1327-1339. doi: 10.1136/annrheumdis-2016-209909. Epub 2016 Nov 9.
4
Recent advances in the pathogenesis and management of Raynaud's phenomenon and digital ulcers.雷诺现象和指端溃疡发病机制与治疗的最新进展
Curr Opin Rheumatol. 2016 Nov;28(6):577-85. doi: 10.1097/BOR.0000000000000332.
5
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N Engl J Med. 2016 Aug 11;375(6):556-65. doi: 10.1056/NEJMra1507638.
6
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Ann Pharmacother. 2016 Dec;50(12):1060-1067. doi: 10.1177/1060028016660324. Epub 2016 Jul 26.
7
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8
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J Rheumatol. 2016 Sep;43(9):1665-71. doi: 10.3899/jrheum.151437. Epub 2016 Jun 15.
9
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Rheumatology (Oxford). 2016 Oct;55(10):1906-10. doi: 10.1093/rheumatology/kew224. Epub 2016 Jun 9.
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JAMA. 2016 May 10;315(18):1975-88. doi: 10.1001/jama.2016.5258.
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