Podhaisky H, Hänsgen K, Sternitzky R, Preuss E G
Z Gesamte Inn Med. 1983 Mar 15;38(6):187-91.
Diseases of the terminal vascular system are of particular diagnostic and differential-diagnostic importance in clinical angiology. While in the functional microangiopathies of the skin as a rule disturbances of the vasomotor function without an essential value of the disease are concerned, secondary organic changes of the wall of the vessel not infrequently determine the course and the prognosis of the basic disease (rheumatoid arthritis, collagenoses, hypertension and diabetes). Vasomotor trophic disturbances are observed also post-traumatically, post-operatively, after exposition to cold, in a lesion of the central nervous system and vertebra nerve irritations. For the allergic hyperergic vasculitides, which show an extraordinary polymorphism in the clinical picture in characteristic histological findings, an auto-immune pathogenesis is to be supposed. The chronic arterial hypertension leads to arteriolosclerosis and necrosis with adequate organic symptoms. In the diabetic microangiopathy we may demarcate functional pre-stages from irreversible structural changes of the vessels, in which case apart from the peripheral microangiopathy of the skin the retinopathy and nephropathy are to be classified as particularly important clinical manifestations.
在临床血管病学中，终末血管系统疾病具有特殊的诊断和鉴别诊断意义。在皮肤功能性微血管病中，通常涉及血管运动功能紊乱，而疾病本身并无本质性病变，但血管壁的继发性器质性改变常常决定基础疾病（类风湿性关节炎、胶原病、高血压和糖尿病）的病程和预后。血管运动性营养障碍也见于创伤后、手术后、受冷后、中枢神经系统病变及脊神经刺激。对于过敏性超敏性血管炎，其临床表现具有特殊的多态性且有特征性组织学表现，推测其发病机制为自身免疫性。慢性动脉高血压会导致小动脉硬化和坏死，并伴有相应的器质性症状。在糖尿病微血管病中，我们可以区分血管功能性前期和不可逆的结构性改变，在这种情况下，除了皮肤外周微血管病外，视网膜病变和肾病被归类为特别重要的临床表现。
