Bobeică Carmen, Tatu Alin Laurențiu, Crăescu Mihaela, Solovăstru Laura
Department of Dermato-Venereology, Doctoral School, University of Medicine and Pharmacy 'Gr. T. Popa' Iaşi, 700115 Iaşi, Romania.
Department of Morphological and Functional Sciences, 'Dunărea de Jos' University of Galaţi, Faculty of Medicine and Pharmacy, 800216 Galaţi, Romania.
Exp Ther Med. 2020 Jul;20(1):61-67. doi: 10.3892/etm.2020.8572. Epub 2020 Feb 27.
Systemic sclerosis (SSc) is a collagenosis with insufficiently known etiopathogenesis, characterized by microvasculopathy and excessive fibrosis in the context of an autoimmune disorder. The incompletely elucidated pathogenesis and limited therapeutic options, disabling aspects, skin lesions and pain determine important functional and psychological deficiencies which affect the quality of life. It is imperative to observe and correlate individual clinical and paraclinical data to optimize disease management. A group of 22 patients diagnosed with SSc, hospitalized in a university clinic in Bucharest was included in an observational study. The evolution of digital ulcers was evaluated as an indicator of vasculopathy and their status and dynamics were correlated with clinical elements reflecting the fibrotic aspect of the disease. The present study shows that the Raynaud phenomenon is almost always present during the course of the disease, but its presence is not always associated with digital ulcers. The existing data in the literature show that fibrosis is subsequent to vasculopathy, but this study did not reveal causality between these two aspects of pathogenesis. The presence of microstomia and digital contracture was identified in the presence of digital ulcers, but also in their absence. The etiopathogenic mechanisms with multiple unknown involved factors open the opportunity to investigate many aspects of SSc for optimal aiming of therapeutic interventions.
系统性硬化症（SSc）是一种病因发病机制尚不完全清楚的胶原病，其特征为在自身免疫性疾病背景下出现微血管病变和过度纤维化。发病机制尚未完全阐明、治疗选择有限、致残情况、皮肤病变及疼痛导致了严重的功能和心理缺陷，影响生活质量。观察并关联个体临床和辅助检查数据以优化疾病管理势在必行。一项观察性研究纳入了22例诊断为SSc并在布加勒斯特一家大学诊所住院的患者。将指端溃疡的演变作为血管病变的指标进行评估，并将其状态和动态变化与反映疾病纤维化方面的临床因素相关联。本研究表明，雷诺现象在疾病过程中几乎总是存在，但它的存在并不总是与指端溃疡相关。文献中的现有数据表明纤维化继发于血管病变，但本研究未揭示这两个发病机制方面之间的因果关系。在有指端溃疡的情况下以及无指端溃疡时均发现有小口症和指挛缩。涉及多种未知因素的病因发病机制为研究SSc的诸多方面以实现治疗干预的最佳目标提供了机会。
