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皮肌炎与系统性硬化症患者甲襞毛细血管镜变化的长期随访。

Long-term follow-up of nailfold videocapillaroscopic changes in dermatomyositis versus systemic sclerosis patients.

机构信息

Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, San Martino Polyclinic Hospital, University of Genova, Viale Benedetto XV, no. 6, 16132, Genoa, Italy.

Autoimmunity Laboratory, Department of Internal Medicine, San Martino Polyclinic Hospital, University of Genova, Genoa, Italy.

出版信息

Clin Rheumatol. 2018 Oct;37(10):2723-2729. doi: 10.1007/s10067-018-4211-2. Epub 2018 Jul 13.

Abstract

To identify nailfold videocapillaroscopy (NVC) changes in patients with dermatomyositis (DM) during a 3-year follow-up and to compare the NVC findings between DM and systemic sclerosis (SSc) patients at their first visit. Retrospective study of 24 DM and 24 SSc patients, matched for age and disease duration at first NVC. Capillaroscopic patterns/scores and clinical parameters had been yearly assessed. Nineteen out of 24 DM patients (79%) showed a NVC "scleroderma-like pattern." No statistically significant variation of all the capillaroscopic scores was observed during the 3-year follow-up. By comparing DM patients with or without anti-Jo-1 positivity, no statistically significant difference of the scores of the main capillary parameters was observed at baseline between the groups. Comparing at baseline DM with SSc patients, the giant capillary and microhemorrhage scores were significantly higher in SSc than those in DM patients (p = 0.04 and p = 0.05, respectively), while capillary density, ramification (abnormally shaped capillaries, expression of angiogenesis), and disorganization scores were higher in DM patients (p = 0.05, p = 0.002, p = 0.004, respectively). The absolute number of ramified capillaries was significantly higher in DM patients (p = 0.002), while the absolute capillary number was significantly higher in SSc patients (p = 0.05) at baseline. This pilot study demonstrates, for the first time, over long-term, that the capillaroscopic manifestations of DM persist in contrast to the progressive changes described in SSc patients, and the anti-Jo-1 positivity does not seem to modify the NVC pattern.

摘要

目的

在 3 年的随访中,识别皮肌炎(DM)患者的甲襞毛细血管镜(NVC)变化,并比较 DM 和系统性硬化症(SSc)患者首次就诊时的 NVC 结果。

方法

回顾性研究 24 例 DM 和 24 例 SSc 患者,按首次 NVC 时的年龄和疾病持续时间进行匹配。每年评估毛细血管模式/评分和临床参数。

结果

24 例 DM 患者中有 19 例(79%)出现 NVC“硬皮病样模式”。在 3 年的随访过程中,所有毛细血管评分均无统计学显著变化。比较 DM 患者中抗 Jo-1 阳性与阴性患者,两组间基线时主要毛细血管参数评分无统计学显著差异。比较 DM 与 SSc 患者,SSc 患者的巨毛细血管和微出血评分明显高于 DM 患者(p=0.04 和 p=0.05),而 DM 患者的毛细血管密度、分支(异常形状的毛细血管、血管生成的表达)和紊乱评分较高(p=0.05、p=0.002、p=0.004)。DM 患者的分支毛细血管绝对数量明显较高(p=0.002),而 SSc 患者的毛细血管绝对数量明显较高(p=0.05)。

结论

这项初步研究首次证明,DM 的毛细血管镜表现长期存在,与 SSc 患者描述的进行性变化形成对比,抗 Jo-1 阳性似乎不会改变 NVC 模式。

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