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甲襞毛细血管镜检查异常与系统性硬化症患者的皮肤和内脏受累相关。

Nailfold capillaroscopy abnormalities correlate with cutaneous and visceral involvement in systemic sclerosis patients.

作者信息

Sato Lucy T, Kayser Cristiane, Andrade Luís E C

机构信息

Rheumatology Division, Universidade Federal de São Paulo (UNIFESP), CEP 04023-062, São Paulo, Brazil.

出版信息

Acta Reumatol Port. 2009 Apr-Jun;34(2A):219-27.

Abstract

OBJECTIVE

The aim of this study was to correlate quantitative and semiquantitative nailfold capillaroscopy (NFC) parameters with the extent of cutaneous and visceral involvement in systemic sclerosis (SSc) patients.

METHODS

The presence of clinical and serological alterations was evaluated retrospectively and correlated with NFC findings (number of capillary loops/mm, vascular deletion score and number of enlarged and giant capillary loops). For evaluation of disease extension five manifestations were analyzed: finger pad lesions, skin involvement, esophageal involvement, interstitial lung disease, and pulmonary hypertension.

RESULTS

There were 105 NFC examinations in 92 patients, 13 of whom were evaluated at two different time points. Patients with diffuse cutaneous SSc had a higher vascular deletion score than patients with limited cutaneous SSc, sine scleroderma SSc, and overlap syndrome (1.67+/-0.91 vs 0.99+/-0.82; p=0.0005). Modified Rodnan's skin score correlated positively with capillary deletion, evaluated by the vascular deletion score and the number of capillary loops/mm (p<0.001 and p=0.012; respectively). Patients with three or more involved tracts presented lower number of capillary loops/mm (8.00+/-1.69 vs 9.23+/-1.31 capillary loops/mm; p=0.025) and a higher vascular deletion score (1.41+/-0.95 vs 0.73+/-0.76; p=0.027) when compared to patients with less than three affected tracts. Vascular deletion score was significantly higher in patients with anti-Scl-70 antibodies that in patients without anti-Scl-70 antibodies (p=0.02).

CONCLUSIONS

NFC abnormalities correlated positively with the diffuse form of SSc, the degree of cutaneous involvement, the number of affected tracts, and the presence of anti-Scl-70 antibodies.

摘要

目的

本研究旨在将甲襞毛细血管镜检查(NFC)的定量和半定量参数与系统性硬化症(SSc)患者皮肤和内脏受累程度相关联。

方法

回顾性评估临床和血清学改变的存在情况,并将其与NFC检查结果(每毫米毛细血管袢数量、血管缺失评分以及扩张和巨大毛细血管袢数量)相关联。为评估疾病范围,分析了五种表现:指腹病变、皮肤受累、食管受累、间质性肺病和肺动脉高压。

结果

92例患者共进行了105次NFC检查,其中13例在两个不同时间点接受评估。弥漫性皮肤型SSc患者的血管缺失评分高于局限性皮肤型SSc、无硬皮病型SSc和重叠综合征患者(1.67±0.91 vs 0.99±0.82;p = 0.0005)。改良Rodnan皮肤评分与通过血管缺失评分和每毫米毛细血管袢数量评估的毛细血管缺失呈正相关(分别为p < 0.001和p = 0.012)。与受累部位少于三个的患者相比,三个或更多受累部位的患者每毫米毛细血管袢数量更低(8.00±1.69 vs 9.23±1.31个毛细血管袢/毫米;p = 0.025),血管缺失评分更高(1.41±0.95 vs 0.73±0.76;p = 0.027)。抗Scl - 70抗体阳性患者的血管缺失评分显著高于抗Scl - 70抗体阴性患者(p = 0.02)。

结论

NFC异常与SSc的弥漫型、皮肤受累程度、受累部位数量以及抗Scl - 70抗体的存在呈正相关。

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