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甲襞毛细血管显微镜检查和葡萄牙甲襞毛细血管显微镜检查诊所的自身免疫性结缔组织病患者。

Nailfold capillaroscopy and autoimmune connective tissue diseases in patients from a Portuguese nailfold capillaroscopy clinic.

机构信息

Internal Medicine Department 7.2, Hospital Curry Cabral-Centro Hospitalar Universitário Lisboa Central, Rua da Beneficência, 8, 1069-166, Lisbon, Portugal.

出版信息

Rheumatol Int. 2020 Feb;40(2):295-301. doi: 10.1007/s00296-019-04427-0. Epub 2019 Aug 26.

Abstract

Raynaud's phenomenon (RP) is frequent in autoimmune connective tissue diseases (AICTD) and its approach includes nailfold capillaroscopy (NFC), as it is a non-invasive technique that permits direct visualization of the microcirculation. The aim of this study is to analyze and establish clinical correlations between NFC findings and particular aspects of autoimmune disorders. This is a retrospective study. Clinical data from patients attending our NFC clinic were reviewed. Inclusion criteria included AICTD previous diagnosis, which included systemic sclerosis (SSc), mixed connective tissue disease (MCTD), systemic lupus erythematosus (SLE), Sjögren syndrome, inflammatory idiopathic myopathies (IIM), rheumatoid arthritis, undifferentiated connective tissue disease and antiphospholipid syndrome (APS). Videocap version 3.0 biomicroscope was used. NFC score was determined. For statistics, SPSS software was utilized. 384 patients were included; most of them were women, with mean age of 47 years. RP was present in 91% of the patients, with greater prevalence in SSc and MCTD. Scleroderma pattern was the most prevalent NFC pattern, mainly in SSc, MCTD and IIM. Mean capillary density was reduced in IIM, SSc and MCTD. NFC score was worse in SSc, IIM and MCTD. In patients with AICTD, RP is related to microvascular damage and worse NFC score. NFC scleroderma pattern correlates with SSc classification criteria score. In MCTD, scleroderma pattern relates to myositis. SLE and APS reveal significant hemorrhages, but not related to APS antibodies. This study highlights the possible role of NFC as biomarker of AICTD, particularly in SSc and IIM.

摘要

雷诺现象(RP)在自身免疫性结缔组织病(AICTD)中很常见,其方法包括甲襞毛细血管镜检查(NFC),因为它是一种非侵入性技术,可以直接观察微循环。本研究旨在分析和建立 NFC 检查结果与自身免疫性疾病特定方面之间的临床相关性。这是一项回顾性研究。回顾了在我们 NFC 诊所就诊的患者的临床数据。纳入标准包括 AICTD 先前诊断,包括系统性硬化症(SSc)、混合性结缔组织病(MCTD)、系统性红斑狼疮(SLE)、干燥综合征、特发性炎性肌病(IIM)、类风湿关节炎、未分化结缔组织病和抗磷脂综合征(APS)。使用 Videocap 版本 3.0 生物显微镜。确定 NFC 评分。统计学分析采用 SPSS 软件。共纳入 384 例患者;大多数是女性,平均年龄 47 岁。91%的患者存在 RP,SSc 和 MCTD 更为常见。硬皮病样模式是最常见的 NFC 模式,主要见于 SSc、MCTD 和 IIM。IM 中毛细血管密度降低,SSc、MCTD 和 IIM 中 NFC 评分更差。在 AICTD 患者中,RP 与微血管损伤和更差的 NFC 评分相关。NFC 硬皮病样模式与 SSc 分类标准评分相关。在 MCTD 中,硬皮病样模式与肌炎相关。SLE 和 APS 显示出明显的出血,但与 APS 抗体无关。本研究强调了 NFC 作为 AICTD 生物标志物的可能作用,特别是在 SSc 和 IIM 中。

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