Rheumatology and Rehabilitation Department, Assiut University Hospital, Assiut, 71515, Egypt.
Rheumatology and Rehabilitation Department, Sohag University Hospital, Sohag university, Sohag, 82524, Egypt.
Arthritis Res Ther. 2019 Apr 15;21(1):95. doi: 10.1186/s13075-019-1877-z.
BACKGROUND/OBJECTIVES: Systemic sclerosis (SSc) is an autoimmune disease associated with immune abnormalities and widespread vascular lesions, including increased intimal and medial thickness. These changes may be reflected in early atherosclerosis and cardiovascular risks. We aimed in this study to examine the carotid artery intima-media thickness and MRI brain findings in SSc patients and compared them to a group of normal controls. A relationship between these parameters and clinical measures in SSc was also sought.
Seventy-two SSc patients with no central nervous system (CNS) symptoms and 42 healthy controls were included. Clinical and laboratory measures, Medsger's severity scale, and Doppler ultrasound common carotid artery intima-media thickness (CCA-IMT) were measured. Brain fluid-attenuated inversion recovery (FLAIR)-MRI and diffusion-weighted MRI (DWI) were also done.
SSc patients had more CCA-IMT, higher CRP, and more brain MRI hyperintense lesions than controls (P < 0.05). Significant positive correlations existed between CCA-IMT and Medsger vascular (r = 0.7, P = 0.02). The FLAIR-MRI showed multiple hyperintense lesions in 24 patients (33%), ranging 0-36 lesions. SSc patients with more lesions (positive MRI) had longer disease duration (P = 0.001) and left and right carotid artery atheromata (P = 0.001, and 0.013, respectively) than SSc patients with negative MRIs; Medsger vascular score did not separate the SSc groups (P = 0.08).
In systemic sclerosis patients without central nervous system symptoms, MRI lesion numbers correlated with CCA-IMT. MRI abnormalities were found more frequently if CRP was elevated, if the Medsger SSc Severity Scale was increased, or if there was thickened carotid IMT.
背景/目的：系统性硬化症（SSc）是一种与免疫异常和广泛血管病变相关的自身免疫性疾病，包括内膜和中膜增厚。这些变化可能反映在早期动脉粥样硬化和心血管风险中。我们旨在本研究中检查 SSc 患者的颈动脉内膜中层厚度和 MRI 脑发现，并将其与一组正常对照进行比较。还寻求了这些参数与 SSc 临床测量之间的关系。
纳入 72 例无中枢神经系统（CNS）症状的 SSc 患者和 42 例健康对照者。测量临床和实验室指标、Medsger 严重程度评分和多普勒超声颈总动脉内膜中层厚度（CCA-IMT）。还进行了脑液体衰减反转恢复（FLAIR）MRI 和弥散加权 MRI（DWI）。
SSc 患者的 CCA-IMT 更高、CRP 更高且脑 MRI 高信号病变更多（P < 0.05）。CCA-IMT 与 Medsger 血管之间存在显著正相关（r = 0.7，P = 0.02）。FLAIR-MRI 显示 24 例患者（33%）存在多个高信号病变，范围 0-36 个病变。MRI 阳性的 SSc 患者的疾病持续时间更长（P = 0.001），左、右侧颈动脉粥样硬化斑块更多（P = 0.001 和 0.013），而 MRI 阴性的 SSc 患者则较少；Medsger SSc 严重程度评分无法区分 SSc 组（P = 0.08）。
在无中枢神经系统症状的系统性硬化症患者中，MRI 病变数量与 CCA-IMT 相关。如果 CRP 升高、Medsger SSc 严重程度评分增加或颈动脉 IMT 增厚，则更常发现 MRI 异常。
