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雷诺现象:当前概念

Raynaud's phenomenon: Current concepts.

作者信息

Stringer Thomas, Femia Alisa N

机构信息

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA.

出版信息

Clin Dermatol. 2018 Jul-Aug;36(4):498-507. doi: 10.1016/j.clindermatol.2018.04.007. Epub 2018 Apr 10.

Abstract

Raynaud's phenomenon (RP) is a transient, acral, vasospastic phenomenon that manifests with characteristic color changes. This vasospasm, classically triggered by cold temperatures, may also be driven by shifts in temperature, climate, or emotional state. Primary RP (PRP) is a common condition without severe sequelae. Secondary RP (SRP), which may be driven by vascular, autoimmune, hematologic, or endocrine etiologies, can result in digital ulceration, irreversible ischemia and necrosis, and secondary infection. This review delineates the clinical manifestations of both primary and secondary RP, as well as the current understanding of RP epidemiology and pathogenesis. Proper examination, including nailfold capillary microscopy, and laboratory workup for secondary causes of RP are also discussed. The traditional armamentarium of therapies used for RP, as well as newer medical and surgical options, is also summarized with particular regard to the clinical evidence for their efficacy.

摘要

雷诺现象(RP)是一种短暂的、累及肢体末端的血管痉挛现象,表现为特征性的颜色变化。这种血管痉挛通常由寒冷温度触发,也可能由温度、气候或情绪状态的变化引起。原发性雷诺现象(PRP)是一种常见疾病,一般不会导致严重后遗症。继发性雷诺现象(SRP)可能由血管、自身免疫、血液或内分泌病因引起,可导致手指溃疡、不可逆的缺血和坏死以及继发性感染。本综述阐述了原发性和继发性雷诺现象的临床表现,以及目前对雷诺现象流行病学和发病机制的认识。文中还讨论了包括甲襞毛细血管显微镜检查在内的恰当检查方法,以及针对继发性雷诺现象病因的实验室检查。此外,还总结了用于雷诺现象治疗的传统方法,以及更新的药物和手术治疗选择,并特别提及了它们疗效的临床证据。

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