Division of Rheumatology, Department of Internal Medicine, University of Utah and Salt Lake Veterans Affair Medical Center, Salt Lake City, UT, USA.
Division of Epidemiology, Department of Internal Medicine, University of Utah and Salt Lake Veterans Affair Medical Center, Salt Lake City, UT, USA.
Clin Exp Rheumatol. 2019 Jul-Aug;37 Suppl 119(4):97-101. Epub 2019 Sep 17.
The fingers, toes, and tips of the nose and ears have specialised structural and functional features for thermoregulation, and are the most common areas of Raynaud's phenomenon in systemic sclerosis. Digital thermal monitoring (DTM) of vascular reactivity assesses Doppler ultrasound hyperemic, low frequency, blood velocity of radial artery and fingertip vascular function. Flow mediated dilation (FMD) is an indirect measure of endothelial function, perfusion, and vasodilator ability. In this study, we investigated the cross-sectional correlation of FMD and DTM variables to inform an optimised noninvasive study of SSc endothelial function. A student's T-test was used to compare means of DTM across binary variables.
Consented SSc registry patients were included in this analysis. The subjects were prepared for FMD and DTM per standardised guidelines. The SSc clinical features were recorded. Spearman's Rank Correlation was used to assess the strength of a relationship FMD and DTM variables.
Thirty-four SSc subjects had FMD and DTM performed on the same day. Relative (0.42, p=<0.02), absolute FMD (0.41, p<0.02), and shear rate (0.32, p<0.07) were weakly, but significantly correlated with the DTM. Reactive hyperemia (-0.44, p=0.000) was weakly inversely, but significantly related with DTM. Baseline diameter and flow were not significantly related to the DTM.
This non-invasive study of SSc endothelial function suggests that macrocirculation (including relative and absolute FMD, shear rate, and peak hyperemia) and microcirculatory thermoregulation (characterised by DTM) are significantly correlated, thus warrants further prospective study.
手指、脚趾、鼻尖和耳垂具有特殊的结构和功能特征，可用于体温调节，也是系统性硬化症中雷诺现象最常见的部位。血管反应性数字热监测（DTM）评估多普勒超声充血、低频、桡动脉和指尖血管功能的血流速度。血流介导的扩张（FMD）是内皮功能、灌注和血管扩张能力的间接测量。在这项研究中，我们研究了 FMD 和 DTM 变量的横断面相关性，以提供一种优化的 SSc 内皮功能的非侵入性研究。学生 t 检验用于比较二进制变量的 DTM 平均值。
本分析纳入了同意参加 SSc 登记研究的患者。按照标准化指南对受试者进行 FMD 和 DTM 准备。记录 SSc 临床特征。Spearman 秩相关用于评估 FMD 和 DTM 变量之间关系的强度。
34 例 SSc 患者在同一天进行了 FMD 和 DTM 检查。相对 FMD（0.42，p<0.02）、绝对 FMD（0.41，p<0.02）和剪切率（0.32，p<0.07）与 DTM 呈弱但显著相关。反应性充血（-0.44，p=0.000）与 DTM 呈弱负相关，但具有显著相关性。基线直径和流量与 DTM 无显著相关性。
这项对 SSc 内皮功能的非侵入性研究表明，大循环（包括相对和绝对 FMD、剪切率和峰值充血）和微循环体温调节（由 DTM 特征化）显著相关，因此需要进一步的前瞻性研究。
