Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, Rua Ipê, 112/111, Vila Clementino, CEP 04022-005, São Paulo, Brazil.
Rheumatology (Oxford). 2014 Jan;53(1):72-5. doi: 10.1093/rheumatology/ket288. Epub 2013 Sep 17.
The objectives of this study were to evaluate the dynamic behaviour of digital skin microvascular blood flow before and after cold stimulation using laser Doppler imaging (LDI) in children and adolescents with RP secondary to juvenile systemic sclerosis (JSS), primary RP (PRP) and healthy controls and to compare functional abnormalities measured by LDI with structural microvascular abnormalities evaluated by nailfold capillaroscopy (NFC).
Five JSS patients, five children and adolescents with PRP and five healthy controls matched for gender and age were included. All subjects had NFC performed. Finger blood flow (FBF) was measured using the LDI system (Moor Instruments) at baseline and after cold stimulus (CS).
There were a decreased number of capillaries, a greater number of enlarged capillaries and a higher deletion score in JSS patients compared with controls and patients with PRP. The mean baseline FBF was significantly lower in JSS patients compared with controls. There was no difference between the mean baseline FBF in JSS patients compared with patients with PRP. There was a significant decrease in FBF 1 min after CS in all groups followed by blood flow recovery at 20 min after CS in comparison with basal FBF values in controls, but not in JSS and PRP patients.
In JSS patients, LDI showed a lower FBF before and after CS compared with healthy controls and may be an objective and sensitive method for the measurement of digital skin blood flow in RP children.
本研究旨在使用激光多普勒成像(LDI)评估儿童和青少年继发于幼年系统性硬皮病(JSS)、原发性 RP(PRP)和健康对照者的 RP 后冷刺激前后数字皮肤微血管血流的动态变化,并比较 LDI 测量的功能异常与甲襞毛细血管镜(NFC)评估的结构微血管异常。
纳入 5 例 JSS 患者、5 例 PRP 患儿和 5 例性别和年龄匹配的健康对照者。所有受试者均进行 NFC 检查。使用 Moor Instruments 公司的 LDI 系统在基线和冷刺激(CS)后测量指血流量(FBF)。
JSS 患者的毛细血管数量减少,毛细血管扩张数量增加,删除评分高于对照组和 PRP 患者。与对照组相比,JSS 患者的平均基线 FBF 显著降低。与 PRP 患者相比,JSS 患者的平均基线 FBF 无差异。所有组在 CS 后 1 分钟 FBF 均显著降低,随后在 CS 后 20 分钟 FBF 恢复至基础值,但 JSS 和 PRP 患者无此变化。
在 JSS 患者中,LDI 显示 CS 前后 FBF 较健康对照组降低,可能是测量 RP 儿童数字皮肤血流的一种客观、敏感的方法。