Coşkun Benlidayı İlke, Kayacan Erdoğan Esra, Sarıyıldız Aylin
Department of Physical Medicine and Rehabilitation, Çukurova University Faculty of Medicine, Adana, Turkey.
Department of Internal Medicine, Division of Rheumatology, Çukurova University Faculty of Medicine, Adana, Turkey.
Arch Rheumatol. 2021 Jan 15;36(3):341-348. doi: 10.46497/ArchRheumatol.2021.8359. eCollection 2021 Sep.
This study aims to evaluate nailfold capillaroscopic pattern in patents with fibromyalgia and to assess the relation of capillaroscopic parameters with clinical variables and disease-related measures.
This cross-sectional, case-control study included 60 participants (4 males, 56 females; mean age: 44.0±8.2 years; range, 26 to 64 years) between August 2019 and November 2019. All participants were divided into two groups as the primary fibromyalgia group (n=30) who met the 2016 modified American College of Rheumatology Diagnostic Criteria for Fibromyalgia and the control group (n=30) consisting of age- and sex-matched healthy individuals. Nailfold capillaroscopy was performed by a digital microscope under a magnification of 200X. Capillary density, capillary loop diameter, number of dilated, giant and neoangiogenic capillaries, capillary shape, number of avascular areas, micro-aneurysms and micro-hemorrhages were evaluated by an assessor who was blind to the group allocation. In the fibromyalgia group, Widespread Pain Index, Symptom Severity Scale scores, and Fibromyalgia Severity scores were calculated. Health status and presence of benign joint hypermobility syndrome (BJHS) were evaluated using the Fibromyalgia Impact Questionnaire (FIQ) and revised Brighton criteria, respectively.
Of the capillaroscopic parameters, the mean capillary loop diameter, number of micro-aneurysms, avascular areas, and neoangiogenic capillaries were significantly higher in the patient group compared to the controls (p<0.001, p=0.016, p=0.038, and p=0.04, respectively). Nailfold capillaroscopic findings did not significantly differ between the patients with (n=16) and without concomitant BJHS (n=14). Of the disease-related measures, only FIQ score showed a weak correlation with the number of dilated capillaries (p=0.324).
Patients with fibromyalgia have distinct capillaroscopic patterns than healthy population. Capillaroscopic features, in general, are not related to clinical variables and disease-related measures.
本研究旨在评估纤维肌痛患者的甲襞毛细血管镜检查模式，并评估毛细血管镜检查参数与临床变量及疾病相关指标之间的关系。
这项横断面病例对照研究纳入了2019年8月至2019年11月期间的60名参与者（4名男性，56名女性；平均年龄：44.0±8.2岁；范围为26至64岁）。所有参与者被分为两组，一组是符合2016年美国风湿病学会纤维肌痛修订诊断标准的原发性纤维肌痛组（n=30），另一组是由年龄和性别匹配的健康个体组成的对照组（n=30）。使用数字显微镜在200倍放大倍数下进行甲襞毛细血管镜检查。由一名对分组情况不知情的评估人员评估毛细血管密度、毛细血管袢直径、扩张、巨大和新生血管的数量、毛细血管形状、无血管区数量、微动脉瘤和微出血情况。在纤维肌痛组中，计算广泛性疼痛指数、症状严重程度量表得分和纤维肌痛严重程度得分。分别使用纤维肌痛影响问卷（FIQ）和修订的布莱顿标准评估健康状况和良性关节活动过度综合征（BJHS）的存在情况。
在毛细血管镜检查参数中，患者组的平均毛细血管袢直径、微动脉瘤数量、无血管区数量和新生血管数量均显著高于对照组（分别为p<0.001、p=0.016、p=0.038和p=0.04）。伴有（n=16）和不伴有（n=14）BJHS的患者之间，甲襞毛细血管镜检查结果无显著差异。在疾病相关指标中，只有FIQ得分与扩张毛细血管数量呈弱相关性（p=0.324）。
纤维肌痛患者的毛细血管镜检查模式与健康人群不同。总体而言，毛细血管镜检查特征与临床变量及疾病相关指标无关。
