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Современная ревматология

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Синдром Рейно в практике ревматолога

https://doi.org/10.14412/1996-7012-2014-2-48-57

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Аннотация

Синдром Рейно (СР) широко распространен в популяции, преобладает среди женщин и в большинстве случаев дебютирует в возрасте до 30 лет. Впервые синдром описан М. Рейно более 150 лет назад, в дальнейшем был выделен первичный (болезнь Рейно) и вторичный СР. Патофизиология СР до конца неясна, по-видимому, СР является мультифакторным заболеванием. Считается, что причиной чрезмерно выраженного вазоспазма в ответ на провоцирующие стимулы является дефект центральных и локальных механизмов регуляции сосудистого тонуса. Среди этих факторов важными представляются сосудистые эндотелиальные, внутрисосудистые и нейрональные нарушения. Существенную роль в патофизиологии вторичного СР играют структурные изменения сосудов, наблюдаемые при капилляроскопии ногтевого ложа. Диагностика СР предполагает в первую очередь определение его клинического варианта, так как вторичный СР бывает проявлением или предвестником некоторых аутоиммунных, гематологических, эндокринных, неопластических и иных заболеваний. Наиболее часто вторичный СР отмечается у больных с системными ревматическими заболеваниями. Лечение вторичного СР остается неудовлетворительным вследствие неполного представления о патофизиологических механизмах его развития. В настоящее время в лечении СР применяются препараты разных лекарственных групп, включая блокаторы кальциевых каналов, ингибиторы фосфодиэстеразы 5-го типа, антагонисты рецепторов эндотелина и др.

В обзоре рассматриваются вопросы патогенеза, алгоритм ранней и дифференциальной диагностики СР, современные подходы к лечению на основе анализа данных литературы и результатов собственных исследований. 

Об авторе

Р.Т. Алекперов
ФГБУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой» РАМН, Москва, Россия


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Для цитирования:


Алекперов Р. Синдром Рейно в практике ревматолога. Современная ревматология. 2014;8(2):48-57. https://doi.org/10.14412/1996-7012-2014-2-48-57

For citation:


Alekperov R. Raynaud’s phenomenon in the rheumatologist’s practice. Modern Rheumatology Journal. 2014;8(2):48-57. (In Russ.) https://doi.org/10.14412/1996-7012-2014-2-48-57

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ISSN 1996-7012 (Print)
ISSN 2310-158X (Online)