Kahan A, Devaux J Y, Weber S, Nitenberg A, Amor B, Menkes C J, Guerin F, Degeorges M
Service de rhumatologie, Hôpital Cochin, Paris.
Arch Mal Coeur Vaiss. 1988 Apr;81(4):495-500.
Myocardial involvement in systemic sclerosis may be caused, at least in part, by myocardial ischemia due to functional or structural abnormalities of small coronary arteries or arterioles. Coronary reserve, assessed by dipyridamole-induced coronary vasodilatation, was strikingly impaired in patients with systemic sclerosis. Thallium scans have shown numerous myocardial perfusion defects in scleroderma patients. Two studies, using oral nifedipine and intravenous dipyridamole, demonstrated that these thallium-201 myocardial perfusion defects in patients with systemic sclerosis were partially reversible. Finally, the preliminary results of long-term studies suggest that some coronary vasodilators may be beneficial in the long-term treatment of myocardial perfusion abnormalities in systemic sclerosis.
系统性硬化症的心肌受累至少部分可能是由小冠状动脉或小动脉的功能或结构异常导致的心肌缺血引起的。通过双嘧达莫诱导的冠状动脉血管扩张评估的冠状动脉储备在系统性硬化症患者中显著受损。铊扫描显示硬皮病患者有大量心肌灌注缺损。两项分别使用口服硝苯地平和静脉注射双嘧达莫的研究表明，系统性硬化症患者的这些铊-201心肌灌注缺损部分是可逆的。最后，长期研究的初步结果表明，一些冠状动脉血管扩张剂可能对系统性硬化症心肌灌注异常的长期治疗有益。
