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系统性硬皮病患者甲襞微血管病变严重程度、手指真皮厚度与指尖血流灌注的相关性。

Correlations between nailfold microangiopathy severity, finger dermal thickness and fingertip blood perfusion in systemic sclerosis patients.

机构信息

Research Laboratory and Academic Unit of Clinical Rheumatology, Department of Internal Medicine, University of Genova, , Genova, Italy.

出版信息

Ann Rheum Dis. 2014 Jan;73(1):247-51. doi: 10.1136/annrheumdis-2012-202572. Epub 2013 May 3.

Abstract

OBJECTIVE

The aim of this study was to identify possible correlations between nailfold microangiopathy severity, finger dermal thickness (DT) and fingertip blood perfusion (FBP) in systemic sclerosis (SSc) patients.

METHODS

Fifty-seven SSc patients and 37 healthy subjects were enrolled. All patients were evaluated by nailfold videocapillaroscopy (NVC) to classify and score the severity of microangiopathy. Both modified Rodnan skin score (mRss) and skin high-frequency ultrasound were used to detect finger DT. Laser Doppler flowmetry (LDF) was employed to detect FBP.

RESULTS

A positive correlation was found between nailfold microvascular damage severity and both ultrasound-DT (p=0.028) and mRss values (p<0.0001). In particular, both ultrasound-DT and mRss were found progressively higher in patients with 'Early', 'Active' or 'Late' NVC pattern of microangiopathy. A negative correlation was observed between nailfold microvascular damage severity and FBP (p<0.0001), showing the lowest FBP of the patients with more advanced NVC patterns. A negative correlation was observed between FBP, and both ultrasound-DT (p=0.007) and mRss values (p=0.0002). SSc patients showed a higher ultrasound-DT at the level of the fingers, as well as a lower FBP than healthy subjects (p<0.0001).

CONCLUSIONS

This study demonstrates a relationship between nailfold microangiopathy severity, DT and FBP in SSc patients.

摘要

目的

本研究旨在确定系统性硬化症(SSc)患者甲襞微血管病变严重程度、手指真皮厚度(DT)和指尖血流灌注(FBP)之间可能存在的相关性。

方法

纳入 57 例 SSc 患者和 37 例健康对照者。所有患者均行甲襞视频显微镜检查(NVC)评估,对微血管病变严重程度进行分类和评分。采用改良罗德南皮肤评分(mRss)和皮肤高频超声检测手指 DT。采用激光多普勒血流仪(LDF)检测 FBP。

结果

甲襞微血管损伤严重程度与超声-DT(p=0.028)和 mRss 值(p<0.0001)呈正相关。特别是,具有“早期”、“活动期”或“晚期”NVC 微血管病变模式的患者,超声-DT 和 mRss 值均逐渐升高。甲襞微血管损伤严重程度与 FBP 呈负相关(p<0.0001),表明 NVC 模式更严重的患者 FBP 最低。FBP 与超声-DT(p=0.007)和 mRss 值(p=0.0002)呈负相关。SSc 患者手指处的超声-DT 较高,而 FBP 低于健康对照组(p<0.0001)。

结论

本研究表明 SSc 患者的甲襞微血管病变严重程度与 DT 和 FBP 之间存在相关性。

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