系统性硬化症（硬皮病）

系统性硬化症（SSc）或硬皮病是一种自身免疫性进行性疾病，其特征在于由结缔组织增加引起的皮肤纹理和外观的变化。 这种疾病可以影响身体的许多其他部位，但在疾病的早期阶段或局部发生时，它往往只影响皮肤。 2013年，美国风湿病学会（ACR）和欧洲抗风湿病联（EULAR）发布了（改进的）SSc分类指南，该指南对该疾病的早期和局限性皮肤发病更关注。 除了手指上的皮肤增厚外，还有几个因素与新分类中涉及的（微）循环有关。 一个是毛细血管的损伤，可以使用甲褶微循环检查（NVC）检查，并提高2013 EULAR / ACR SSc分类标准的特异性和灵敏度。

近年来，有多项研究表明，激光散斑对比分析（LASCA）可作为重要的诊断工具，用来进一步研究SSc疾病分类。 LASCA分析外周血流灌注并给出其强度值。 如通过NVC评估，LASCA值与SSc微血管损伤的严重性（基于毛细血管数量的得分）相关（参见附图和参考文献）。 LASCA和NVC有助于评估SSc治疗的效果。

推荐产品: PSI NR and Perilont.

离子导入仪

案例（热那亚大学 - 意大利，根特大学 - 比利时）

Maurizio Cutolo (University of Genova - Italy), Barbara Ruaro (University of Genova - Italy), Vanessa Smith (University of Ghent - Belgium)

LASCA分析外周血液灌注并给出其强度值。我们最近使用LASCA进行的研究表明，SSc患者的血液灌注显着低于健康受试者的指尖，周围区域和手掌水平，但不是面部水平2,8

此外，在上述皮肤区域的水平检测到甲襞微循环病变程度和血液灌注程度之间的统计学显着负相关2,8（见图1,2）。此外，我们在SSc患者中证明LASCA是一种安全技术，可监测指/趾溃疡的灌注，在愈合过程中通过局部医疗敷料进行治疗。

我们使用LASCA来评估长期治疗期间用各种药物如波生坦，伊洛前列素和氨基萘酮9,10的血液灌注变化。

总之，LASCA代表了一种必不可少的安全，非侵入性和非接触式工具，用于可靠地量化SSc皮肤和溃疡区域的血液灌注。与NVC一起，监测疾病进展，治疗反应和溃疡情况可能是有用的。

Figure 1. 在SSc患者中LASCA与NVC对比.

Figure 2. LASCA 在对SSc病人进行评估

专家观点

Perimed的PeriCam PSI激光散斑对比成像仪（LASCA）是研究微循环功能的绝佳工具，特别是可以在任何时期研究外周血液灌注和系统性硬化症中的雷诺现象2.治疗对SSc患者微循环的影响的观测 也是LASCA的重要应用。 微循环的LASCA分析（下图）是前列环素静脉血管扩张6天前后的SSc患者.

相关文献

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