Gheorghiu Ana Maria, Oneata Raida, Ancuta Ioan, Enuica Alexandra, Linte Octavian, Macovei Liviu, Bojinca Mihai, Stoica Victor, Mihai Carina
Department of Internal Medicine and Rheumatology, Cantacuzino Clinical Hospital, 'Carol Davila' University of Medicine and Pharmacy, 020475 Bucharest, Romania.
Optoelectronica SA 2001, 050883 Bucharest, Romania.
Exp Ther Med. 2020 Oct;20(4):3438-3443. doi: 10.3892/etm.2020.8979. Epub 2020 Jul 8.
Capillary density on nailfold capillaroscopy (NFC) is considered a promising instrument for assessing disease characteristics in patients with systemic sclerosis (SSc), however, there is no agreement yet over how to analyze and interpret the results. The objective of this study was to investigate the possible associations of the mean number of capillaries with disease characteristics, disease activity [measured by the European Scleroderma Study Group (EScSG) disease activity score] and survival in a single-center cohort of patients with SSc. Sixty-eight patients were included; 54 had follow-up at 6 months. Thirty-two images per patient were assessed independently by two raters, scoring the mean number of capillaries in all fingers (N), in the 3rd finger of the dominant hand (dN) and in the 4th finger of the non-dominant hand (ndN) for each patient. NFC 'early', 'active' and 'late' patterns were also assessed. Two thousand and seventy-six images were scored at baseline, 1,728 at follow-up. Baseline N was median (IQR) 5.1 (2.7) for rater 1, and 4.9 (1.7) for rater 2, respectively. N was significantly lower in patients with a history of digital ulcers (DUs), vs. those who never had DUs 4.8 (1.4) vs. 6.4 (3.1), P=0.016. A lower N was associated with higher disease activity at baseline and follow-up (linear regression adjusted for age, sex and history of DUs). A lower ndN was associated with increased mortality (logistic regression adjusted for age and sex). In conclusion, in patients with SSc, a lower mean number of capillaries assessed by NFC was associated with higher disease activity after 6 months of follow-up and with shorter survival.
甲襞毛细血管镜检查（NFC）中的毛细血管密度被认为是评估系统性硬化症（SSc）患者疾病特征的一种有前景的手段，然而，对于如何分析和解读结果尚无共识。本研究的目的是在一个单中心的SSc患者队列中，调查毛细血管平均数量与疾病特征、疾病活动度[通过欧洲硬皮病研究组（EScSG）疾病活动评分来衡量]及生存率之间的可能关联。纳入了68例患者；其中54例进行了6个月的随访。两名评估者独立评估每位患者的32张图像，对每位患者所有手指的毛细血管平均数量（N）、优势手第3指的毛细血管平均数量（dN）和非优势手第4指的毛细血管平均数量（ndN）进行评分。还评估了NFC的“早期”“活动期”和“晚期”模式。基线时对2760张图像进行了评分，随访时对1728张图像进行了评分。评估者1的基线N中位数（IQR）为5.1（2.7），评估者2的为4.9（1.7）。有指端溃疡（DU）病史的患者的N显著低于从未有过DU的患者，分别为4.8（1.4）和6.4（3.1），P = 0.016。较低的N与基线和随访时较高的疾病活动度相关（经年龄、性别和DU病史校正的线性回归）。较低的ndN与死亡率增加相关（经年龄和性别校正的逻辑回归）。总之，在SSc患者中，NFC评估的较低毛细血管平均数量与随访6个月后较高的疾病活动度及较短的生存期相关。
