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糖尿病中的甲襞毛细血管镜检查。

Nailfold capillaroscopy in diabetes mellitus.

作者信息

Maldonado G, Guerrero R, Paredes C, Ríos C

机构信息

Universidad de Especialidades Espíritu Santo, Km. 2.5 Vía la Puntilla, Samborondón, Ecuador.

Centro de Reumatología y Rehabilitación, El Oro y Ambato, 1004 Guayaquil, Ecuador.

出版信息

Microvasc Res. 2017 Jul;112:41-46. doi: 10.1016/j.mvr.2017.03.001. Epub 2017 Mar 6.

Abstract

INTRODUCTION

Diabetes mellitus (DM) is characterized by chronic hyperglycemia states and the development of specific microvascular disorders such as retinopathy and nephropathy. Conventional methods are used to study the vascular compromise of this entity, however, the use of capillaroscopy for the evaluation of capillary microarchitecture is not frequently used.

METHODS AND MATERIALS

Observational and descriptive study of 65 patients with an established diagnosis of DM and a control group that underwent an initial capillaroscopy examination. The parameters considered were: Capillary diameter (ectasia and giant capillaries), cross-linked, tortuous, arborified capillaries, avascular zones, haemorrhages, dominant morphology, visibility of the subpapillary venous plexus (SPVP), cuticulitis and SD pattern.

RESULTS

Capillaroscopy was performed in 65 patients, the findings were: tortous capillaries (63%), crosslinked capillaries (59%), avascular areas (48%), ectasias (39%), giant capillaries (11%). The capillaroscopic findings were evident in the majority of the studied population, 83%, compared to 17% who did not have capillaroscopic alterations.

CONCLUSION

Significant capillaroscopic changes were demonstrated in patients with DM, in turn, we described a specific pattern consisting of: capillary dilatation, avascular zones and tortuous capillaries. Patients with more comorbidities and evolution of the disease showed greater microvascular damage.

摘要

引言

糖尿病(DM)的特征是慢性高血糖状态以及特定微血管疾病的发展,如视网膜病变和肾病。传统方法用于研究该疾病的血管损害,然而,毛细血管显微镜检查在评估毛细血管微结构方面的应用并不常见。

方法与材料

对65例确诊为糖尿病的患者和一个对照组进行观察性和描述性研究,这些患者均接受了初次毛细血管显微镜检查。所考虑的参数包括:毛细血管直径(扩张和巨大毛细血管)、交联、扭曲、树状毛细血管、无血管区、出血、主要形态、乳头下静脉丛(SPVP)的可见性、角质层炎和SD模式。

结果

对65例患者进行了毛细血管显微镜检查,结果如下:扭曲毛细血管(63%)、交联毛细血管(59%)、无血管区(48%)、扩张(39%)、巨大毛细血管(11%)。在大多数研究人群(83%)中,毛细血管显微镜检查结果明显,而无毛细血管显微镜改变的患者占17%。

结论

糖尿病患者表现出明显的毛细血管显微镜改变,反过来,我们描述了一种特定模式,包括:毛细血管扩张、无血管区和扭曲的毛细血管。合并症更多且疾病进展的患者显示出更大的微血管损伤。

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