Rajendran Aarthi, Maikap Debashis, Padhan Prasanta, Misra Ramnath, Singh Pratima
Department of Pulmonary Medicine, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India.
Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India.
Mediterr J Rheumatol. 2023 Sep 14;35(2):263-271. doi: 10.31138/mjr.260423.cnv. eCollection 2024 Jun.
To differentiate the nailfold capillaroscopy (NFC) findings in patients with MCTD-ILD and SSc-ILD and correlate the NFC changes and lung functions among them.
In this observational study from Oct 2020 to Oct 2022, 27 patients with MCTD-ILD and 27 patients with SSc-ILD were included. NFC was performed using Jiangsu Jiahua, JH 1004, China. Statistical analysis was conducted using IBM SPSS software, version 26, and tests including Mann-Whitney U-test, student t-test, chi-square test, or Fisher's exact test were used to compare between groups.
In this study, major capillaroscopic changes were more frequent in SSc-ILD group (92%) than in MCTD-ILD group (72.3%), with normal capillaries seen in 7.4% of MCTD-ILD cases. The mean FVC was higher in SSc-ILD group compared to MCTD-ILD group, and patients with capillary loss had a lower mean FVC. Loss of capillaries was more frequent in SSc-ILD group, while dilated capillaries were predominantly observed in MCTD-ILD group. A significant association was found between the severity of restriction in spirometry and NFC.
There is an important role for NFC in detecting the severity of lung involvement, as the grading of restrictive severity in spirometry is strongly associated with capillaroscopic abnormalities.
鉴别混合性结缔组织病相关间质性肺病(MCTD-ILD)和系统性硬化症相关间质性肺病(SSc-ILD)患者的甲襞毛细血管镜检查(NFC)结果,并关联两者之间的NFC变化和肺功能。
在这项2020年10月至2022年10月的观察性研究中,纳入了27例MCTD-ILD患者和27例SSc-ILD患者。使用中国江苏嘉华JH 1004进行NFC检查。采用IBM SPSS 26软件进行统计分析,使用曼-惠特尼U检验、学生t检验、卡方检验或费舍尔精确检验进行组间比较。
在本研究中,SSc-ILD组主要毛细血管镜改变的发生率(92%)高于MCTD-ILD组(72.3%),7.4%的MCTD-ILD病例可见正常毛细血管。SSc-ILD组的平均用力肺活量(FVC)高于MCTD-ILD组,毛细血管缺失的患者平均FVC较低。毛细血管缺失在SSc-ILD组更常见,而扩张的毛细血管主要在MCTD-ILD组观察到。肺活量测定中受限的严重程度与NFC之间存在显著关联。
NFC在检测肺部受累的严重程度方面具有重要作用,因为肺活量测定中限制性严重程度的分级与毛细血管镜异常密切相关。