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甲襞毛细血管发现与系统性红斑狼疮轻度认知功能障碍之间无关联。

Absence of association between nailfold capillary findings and mild cognitive dysfunction in systemic lupus erythematosus.

机构信息

Department of Rheumatology, Medicine School, Meritorious Autonomous University of Puebla, Puebla, Mexico.

Systemic Autoimmune Diseases Research Unit, Specialties Hospital UMAE-CIBIOR, Mexican Social Security Institute, 2 Norte 2004, 72000, Puebla, Mexico.

出版信息

Clin Rheumatol. 2022 Sep;41(9):2737-2743. doi: 10.1007/s10067-022-06215-x. Epub 2022 May 27.

Abstract

OBJECTIVE

The role of vascular damage in cognitive dysfunction (CD) in SLE is not entirely understood. Nailfold capillaroscopy (NFC) is a noninvasive method that may aid the description of further vascular contributions to CD in SLE. Therefore, the aim of our study was to examine and compare finger nailfold capillary morphology in subjects with SLE with and without CD.

METHODS

We conducted a cross-sectional study in patients with SLE. Demographic, clinical, and laboratory characteristics were collected. We evaluated nailfold capillary findings including avascular zones, hemorrhage, dilated and tortuous capillaries, disarrangement, crossing, subpapillary venular plexus, branched loops, and shortened loops by NFC. The Montreal Cognitive Assessment (MoCA) scale was used to screen cognitive function. CD was defined as a score < 26/30.

RESULTS

Sixty-five females (97.0%) and 2 males (3%) with SLE were analyzed. Means of age and disease duration were 44.3 ± 12.0 years and 15.5 ± 7.6 years, respectively. Thirty-five (54.7%) patients had CD. The rate of patients with ≥ 1 NFC abnormality was 50% in both patients with and without CD (P = 0.14). Eight (22.8%) patients with CD compared to 1 without (3.5%) displayed dilated capillaries (P = 0.036). Other NFC abnormalities differed between patients with and without CD, but the possible relationships between dilated capillaries and CD disappeared after adjusting by age, diabetes, and hypertension.

CONCLUSIONS

NFC findings were not associated with mild CD in patients with SLE. Our exploratory data do not support systemic microvasculopathy measured by NFC related to CD in patients with SLE.

摘要

目的

血管损伤在系统性红斑狼疮(SLE)认知功能障碍(CD)中的作用尚不完全清楚。甲襞毛细血管显微镜检查(NFC)是一种非侵入性方法,可能有助于描述 SLE 患者 CD 中进一步的血管贡献。因此,我们的研究目的是检查和比较有 CD 和无 CD 的 SLE 患者的手指甲襞毛细血管形态。

方法

我们进行了一项 SLE 患者的横断面研究。收集了人口统计学、临床和实验室特征。我们通过 NFC 评估了指甲毛细血管的发现,包括无血管区、出血、扩张和扭曲的毛细血管、排列紊乱、交叉、皮下静脉丛、分支环和缩短环。使用蒙特利尔认知评估(MoCA)量表筛查认知功能。CD 的定义为评分<26/30。

结果

分析了 65 名女性(97.0%)和 2 名男性(3%)的 SLE 患者。年龄和疾病持续时间的平均值分别为 44.3±12.0 岁和 15.5±7.6 岁。35 名(54.7%)患者有 CD。有 CD 和无 CD 的患者中,至少有 1 种 NFC 异常的患者比例分别为 50%(P=0.14)。8 名(22.8%)有 CD 的患者与 1 名无 CD 的患者(3.5%)相比,扩张的毛细血管更多(P=0.036)。NFC 异常在有 CD 和无 CD 的患者之间存在差异,但在调整年龄、糖尿病和高血压后,扩张的毛细血管与 CD 之间的可能关系消失了。

结论

NFC 发现与 SLE 患者的轻度 CD 无关。我们的探索性数据不支持 NFC 测量的系统性微血管病与 SLE 患者的 CD 相关。

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