rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2013-1501rsp-1317Research ArticleСтатьиArticlesМикроциркуляторные нарушения при системной склеродермии — взаимосвязь с жесткостью сосудистой стенкиMicrocirculatory disorders in scleroderma systematica: an association with vascular wall stiffnessRuzhentsovaUlyana YuryevnaRuzhentsovaUlyana Yuryevnaruljana@mail.ru201315062013513№3 (2013)275278Copyright © Ruzhentsova U.Y., 20132013Ruzhentsova U.Y.Ruzhentsova U.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/1317

Цель исследования — изучить особенности регуляции тонуса периферических сосудов, а также их взаимосвязь со структурно-функциональным состоянием эндотелия сосудов крупного калибра у больных системной склеродермией (ССД). Материал и методы. В исследование включены 25 больных ССД (средний возраст 47±2,6 года, средняя длительность заболевания 8,3±1,7 года) и 15 практически здоровых лиц, сопоставимых по возрасту и полу. Комплексное обследование включало лабораторные и инструментальные методы, лазерную допплерографию для оценки эндотелий-зависимой и эндотелий-независимой вазодилатации, а также аппланационную тонометрию с вычислением скорости пульсовой волны и индекса аугментации. Результаты. У всех больных ССД выявлено нарушение периферической сосудистой реактивности в сравнении с контролем. В ходе исследования была установлена зависимость выраженности показателей эндотелий-зависимой вазодилатации от индекса жесткости сосудов крупного калибра. Взаимосвязи между эндотелий-независимой вазодиатацией и показателями эластичности сосудов не выявлено.

Objective: to study the specific features of regulation of peripheral vascular tone and their association with the endothelial structure and function of large vessels in patients with scleroderma systematica (SDS). Subjects and methods. The investigation enrolled 25 patients with SDS (mean age, 47±2.6 years; mean disease duration, 8.3+1.7 years) and 15 apparently healthy individuals matched for age and gender. Comprehensive examination involved laboratory and instrumental studies, laser Doppler study to evaluate endothelium-dependent and endothelium-independent vasodilation, as well as applanation tonometry calculating the pulse wave velocity and augmentation index. Results. All the patients were found to have impaired peripheral vascular responsiveness as compared to the controls. The examination established a relationship between the magnitude of endothelium-dependent vasodilation and the stiffness index of large vessels. There was no association between endothelium-independent vasodilation and vascular elasticity parameters.

системная склеродермияпериферическая сосудистая реактивностьмикроциркуляторные нарушенияжесткость сосудистой стенкиscleroderma systematicaperipheral vascular responsivenessmicrocirculatory disordersvascular wall stiffnessReferences<div><p>Chung L., Fiorentino D. Digital ulcers in patients with systemic sclerosis. Autoimmun Rev 2006;5:125-8.</p><p>Ioannidis J.P., Vlachoyiannopoulos P.G., Haidich A.B. et al. Mortality in systemic sclerosis: an international meta-analysis of individual patient data. Am J Med 2005;118:2-10.</p><p>Ho M., Veale D., Eastmond C. et al. Macrovascular disease and systemic sclerosis. Ann Rhoum Dis 2000;59:39-43.</p><p>Takagi K., Kawaguchi Y., Hara M. et al. Serum nitric oxide (NO) levels in systemic sclerosis patients: correlation between NO levels and clinical features. Clin Exp Immunol 2003;134:434-45.</p><p>Preliminary criteria for the classification of systemic sclerosis (scleroderma). Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Arthr Rheum 1980;23:581-90.</p><p>Rushentsova U., Opazo Saez A.M., Mosel F. et al. Laser Doppler imager (LDI) scanner and intradermal injection for in vivo pharmacology in human skin microcirculation: responses to acetylcholine, endothelin-1 and their repeatability. Br J Clin Pharmacol 2005;59:511-9.</p><p>Gunawardena H., Harris N.D., Carmichael C. et al. Maximum blood flow and microvascular regulatory responses in systemic sclerosis Rheumatology (Oxford) 2007;46:1079-82.</p><p>Hamilton P.K., Lockhart C.J., Quinn C.E. et al. Arterial stiffness: clinical relevance, measurement and treatment. Clin Sci (Lond) 2007;113:157-70.</p><p>Moyssakis I., Gialafos E., Vassiliou V. et al. Aortic stiffness in systemic sclerosis is increased independently of the extent of skin involvement. Rheumatology (Oxford) 2005;44:251-4.</p><p>Hope S.A., Hughes A.D. Drug effects on the mechanical properties of large arteries in humans. Clin Exp Pharmacol Physiol 2007;34:688-93.</p><p>Cypiene A., Laucevicius A., Venalis A. et al. The impact of systemic sclerosis on arterial wall stiffness parameters and endothelial function. Clin Rheumatol 2008;27:1517-22.</p><p>Dooley A., Gao A., Bradley N. et al. Abnormal nitric oxide metabolism in systemic sclerosis: increased levels of nitrated proteins and asymmetric dimethylarginine. Rheumatology (Oxford) 2006;45:676-84.</p><p>Matucci Cerinic M., Kahaleh M.B. Beauty and the beast. The nitric oxide paradox in systemic sclerosis. Rheumatology (Oxford) 2002;41:843-7.</p><p>Constans J., Germain C., Gosse P. et al. Arterial stiffness predicts severe progression in systemic sclerosis: the ERAMS study J Hypertens 2007;25:1900-6.</p></div><br /><div><p>Chung L., Fiorentino D. Digital ulcers in patients with systemic sclerosis. Autoimmun Rev 2006;5:125-8.</p><p>Ioannidis J.P., Vlachoyiannopoulos P.G., Haidich A.B. et al. Mortality in systemic sclerosis: an international meta-analysis of individual patient data. Am J Med 2005;118:2-10.</p><p>Ho M., Veale D., Eastmond C. et al. Macrovascular disease and systemic sclerosis. Ann Rhoum Dis 2000;59:39-43.</p><p>Takagi K., Kawaguchi Y., Hara M. et al. Serum nitric oxide (NO) levels in systemic sclerosis patients: correlation between NO levels and clinical features. Clin Exp Immunol 2003;134:434-45.</p><p>Preliminary criteria for the classification of systemic sclerosis (scleroderma). Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Arthr Rheum 1980;23:581-90.</p><p>Rushentsova U., Opazo Saez A.M., Mosel F. et al. Laser Doppler imager (LDI) scanner and intradermal injection for in vivo pharmacology in human skin microcirculation: responses to acetylcholine, endothelin-1 and their repeatability. Br J Clin Pharmacol 2005;59:511-9.</p><p>Gunawardena H., Harris N.D., Carmichael C. et al. Maximum blood flow and microvascular regulatory responses in systemic sclerosis Rheumatology (Oxford) 2007;46:1079-82.</p><p>Hamilton P.K., Lockhart C.J., Quinn C.E. et al. Arterial stiffness: clinical relevance, measurement and treatment. Clin Sci (Lond) 2007;113:157-70.</p><p>Moyssakis I., Gialafos E., Vassiliou V. et al. Aortic stiffness in systemic sclerosis is increased independently of the extent of skin involvement. Rheumatology (Oxford) 2005;44:251-4.</p><p>Hope S.A., Hughes A.D. Drug effects on the mechanical properties of large arteries in humans. Clin Exp Pharmacol Physiol 2007;34:688-93.</p><p>Cypiene A., Laucevicius A., Venalis A. et al. The impact of systemic sclerosis on arterial wall stiffness parameters and endothelial function. Clin Rheumatol 2008;27:1517-22.</p><p>Dooley A., Gao A., Bradley N. et al. Abnormal nitric oxide metabolism in systemic sclerosis: increased levels of nitrated proteins and asymmetric dimethylarginine. Rheumatology (Oxford) 2006;45:676-84.</p><p>Matucci Cerinic M., Kahaleh M.B. Beauty and the beast. The nitric oxide paradox in systemic sclerosis. Rheumatology (Oxford) 2002;41:843-7.</p><p>Constans J., Germain C., Gosse P. et al. Arterial stiffness predicts severe progression in systemic sclerosis: the ERAMS study J Hypertens 2007;25:1900-6.</p></div><br />

The authors declare that there are no conflicts of interest present.