Rajaei Alireza, Dehghan Pooneh, Amiri Ali
Department of Rheumatology, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Radiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Caspian J Intern Med. 2017 Fall;8(4):269-274. doi: 10.22088/cjim.8.4.269.
Microvascular changes are one of the first obvious steps in numerous inflammatory diseases such as rheumatoid arthritis (RA). Nailfold video capillaroscopy (NFC) is an easy, reliable and safe method for evaluating peripheral microangiopathy. The objective of this study was to examine nailfold microcirculation in RA patients, assess morphological and structural changes quantitatively and qualitatively, and recognize useful changes.
A total of 430 patients diagnosed with RA were examined in a period of 4 years. NFC was performed on all fingers of both hands in each patient. Different parameters indicating microvascular changes were detected and analyzed; such as microvascular architecture, capillary distribution disturbances, capillary morphology, capillary density, efferent/afferent limb ratio, subpapillary venular plexus and morphological abnormalities. The obtained results were categorized into normal pattern, nonspecific morphological abnormality and scleroderma pattern.
The mean age of participants was 51.03±14.54 (19-87 years) that consisted of 359 females and 71 males. Based on the findings, angiogenesis (74.7%) was the most pathological condition observed after tortuosity (99.5%). 7.2% and 20.9% of patients were categorized into normal and scleroderma pattern group, respectively. Among morphological abnormalities, angiogenesis, isolated enlarged loop, irregular enlarged loop and architectural derangement were significantly more frequent in scleroderma than normal pattern (p<0.001).
NFC may play an important role in monitoring RA disease and patients' follow-up. Therefore, in our opinion it could be considered in the course and follow-up of rheumatoid arthritis.
微血管变化是类风湿关节炎（RA）等众多炎症性疾病最早出现的明显变化之一。甲襞视频毛细血管镜检查（NFC）是一种评估外周微血管病变的简便、可靠且安全的方法。本研究的目的是检查RA患者的甲襞微循环，定量和定性评估形态和结构变化，并识别有用的变化。
在4年期间共检查了430例诊断为RA的患者。对每位患者双手的所有手指进行NFC检查。检测并分析指示微血管变化的不同参数；如微血管结构、毛细血管分布紊乱、毛细血管形态、毛细血管密度、输出/输入支比例、乳头下静脉丛和形态异常。将获得的结果分为正常模式、非特异性形态异常和硬皮病模式。
参与者的平均年龄为51.03±14.54岁（19 - 87岁），其中女性359例，男性71例。根据研究结果，血管生成（74.7%）是继迂曲（99.5%）之后观察到的最常见病理状况。分别有7.2%和20.9%的患者被归入正常模式组和硬皮病模式组。在形态异常中，硬皮病模式组的血管生成、孤立性扩大襻、不规则扩大襻和结构紊乱明显比正常模式组更常见（p<0.001）。
NFC可能在监测RA疾病和患者随访中发挥重要作用。因此，我们认为在类风湿关节炎的病程和随访中可以考虑采用。
