Kaminska-Winciorek Grażyna, Deja Grażyna, Polańska Joanna, Jarosz-Chobot Przemysława
Department of Dermatology, Silesian Medical University, Katowice.
Postepy Hig Med Dosw (Online). 2012 Jan 30;66:51-9.
The aim of this work was a quantitative and qualitative assessment of a selected part of the microcirculation in children with diabetes type 1 using videocapillaroscopy technique.
MATERIAL/METHODS: The authors tested a group consisting of 145 children (70 boys, 75 girls) diagnosed and treated for diabetes type 1 in the Diabetic Clinic of GCZD in Katowice for at least one year. The study included history, clinical examination (including dermatological examination) and videocapillaroscopy. Capillaroscopy, a non-invasive, painless and easily repeatable test, was performed using videocapillaroscopy with digital storage of the obtained images. All nailfolds were examined in all children using videocapillaroscopy, and the obtained images were assessed quantitatively and qualitatively for changes in capillary loops in the tested children according to the defined diagnostic procedure.
The analysis of capillaroscopic images described selected quantitative and qualitative characteristics. The conducted analysis showed an increase in the number of capillaries and their elongation, the presence of megacapillaries and Raynaud loops, which were accompanied by an intensive red background, indicating possible neoangiogenesis. The increase in the number of capillaries, disturbances in distribution of capillaries and the presence of abnormal capillaries were correlated with the longer duration of diabetes. Raynaud loops were more frequently found in the cases of increased mean values of HbA1c. Higher values of HbA1c influenced the capillaroscopic images, mainly the number of vessels, including Raynaud loops.
Videocapillaroscopy technique could be a useful tool to detect the early changes of microangiopathy in children with diabetes type 1.
本研究旨在使用视频毛细血管显微镜技术对1型糖尿病患儿微循环的选定部分进行定量和定性评估。
材料/方法：作者测试了一组由145名儿童（70名男孩，75名女孩）组成的群体，这些儿童在卡托维兹GCZD糖尿病诊所被诊断为1型糖尿病并接受治疗至少一年。研究包括病史、临床检查（包括皮肤科检查）和视频毛细血管显微镜检查。毛细血管显微镜检查是一种无创、无痛且易于重复的检查，使用视频毛细血管显微镜进行，并对获得的图像进行数字存储。所有儿童均使用视频毛细血管显微镜检查所有甲襞，并根据定义的诊断程序对获得的图像进行定量和定性评估，以检测受试儿童毛细血管袢的变化。
对毛细血管显微镜图像的分析描述了选定的定量和定性特征。进行的分析显示毛细血管数量增加及其伸长，存在巨型毛细血管和雷诺环，同时伴有强烈的红色背景，表明可能存在新生血管形成。毛细血管数量的增加、毛细血管分布的紊乱以及异常毛细血管的存在与糖尿病病程较长相关。在糖化血红蛋白（HbA1c）平均值升高的病例中，雷诺环更常见。较高的HbA1c值影响毛细血管显微镜图像，主要是血管数量，包括雷诺环。
视频毛细血管显微镜技术可能是检测1型糖尿病患儿微血管病变早期变化的有用工具。
