von Bierbrauer Axel, Willert Jörg, Barth Peter
Department of Internal Medicine, City Hospital Neunkirchen, Neunkirchen, Germany.
Rheumatol Int. 2008 Jan;28(3):253-9. doi: 10.1007/s00296-007-0418-2. Epub 2007 Jul 27.
The aim of the study was to evaluate morphologic alterations of microvessels quantitatively and objectively in patients with various connective tissue diseases (CTD) by means of histomorphometry. Standardized histomorphometrical examination of dermal microvessels was performed by means of interactive semi-automated image analysis in specimens obtained by the technique of capillaroscopically guided nailfold biopsy in 31 patients with various CTD and 8 controls without CTD. Histomorphometry revealed a significant enlargement, an increased dysmorphia and a diminished number of microvessels as well as an increased papillary area in CTD-patients compared to controls. The most severe alterations of microvessels were seen in scleroderma and MCTD, whereas in SLE the morphometrically observed changes were less impressive. By means of histomorphometry morphological changes of the microvasculature can be analyzed quantitatively and objectively. Since differences regarding nature and extent of the microvascular injury between particular conditions can be disclosed by the technique, this approach may be a useful tool to identify distinct patterns of microangiopathy in the various types of CTD.
本研究的目的是通过组织形态计量学方法，对各种结缔组织病（CTD）患者的微血管形态改变进行定量和客观评估。采用毛细血管镜引导甲襞活检技术获取标本，对31例各种CTD患者和8例无CTD的对照者的真皮微血管进行标准化组织形态计量学检查，采用交互式半自动图像分析方法。组织形态计量学显示，与对照组相比，CTD患者的微血管显著增大、畸形增加、数量减少以及乳头面积增加。微血管改变最严重的是硬皮病和混合性结缔组织病（MCTD），而系统性红斑狼疮（SLE）在形态计量学上观察到的变化则不那么明显。通过组织形态计量学，可以对微血管系统的形态变化进行定量和客观分析。由于该技术可以揭示特定疾病之间微血管损伤的性质和程度差异，因此这种方法可能是识别各种类型CTD中不同微血管病模式的有用工具。
