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贝赫切特综合征的甲襞毛细血管显微镜检查异常和血管表现。

Nailfold videocapillaroscopy abnormalities and vascular manifestations in Behçet's syndrome.

机构信息

Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Parc Taulí Universitari Hospital, Institut d'Investigació i Innovació Parc Taulí I3PT-CERCA, Universitat Autònoma de Barcelona, Sabadell, Spain.

Systemic Autoimmune Diseases Unit, Vall d'Hebron General Hospital, Universitat Autònoma de Barcelona, Spain.

出版信息

Clin Exp Rheumatol. 2024 Oct;42(10):2065-2070. doi: 10.55563/clinexprheumatol/v5mz8d. Epub 2024 Oct 4.

Abstract

OBJECTIVES

To evaluate microcirculation abnormalities and their clinical association in patients with BS, especially with vascular manifestations.

METHODS

A cross-sectional study was carried out using nailfold videocapillaroscopy (NVC) to evaluate the microcirculation in patients with BS.

RESULTS

A total of 65 patients were included in the study. Thirty-four (52.3%) were men, and 84.6% were European Caucasian. Vascular involvement was present in 24 (36.9%) patients. Qualitative abnormalities in NVC were observed in 47.7% of patients. The most frequent were tortuous and branched capillaries (21.5%), followed by microhaemorrhage (12.3%), enlarged capillary (7.7%) and giant capillary (3.1%). We found a significant relationship between the presence of tortuous and branched capillaries and previous superficial thrombophlebitis (ST) (p=0.025). The presence of ≥2 qualitative abnormalities in NVC was associated with vascular involvement (p=0.031), mainly with venous thrombotic events (p=0.024) and particularly with ST (p=0.003). No specific Cutolo's pattern was observed. No association was observed between NVC and Raynaud's phenomenon or ANA, although patients with positive ANA presented more frequent non-specific capillaroscopic abnormalities (p=0.003).

CONCLUSIONS

The presence of ≥2 qualitative abnormalities in NVC is associated with Vasculo-Behçet. NVC might be a potential tool for early detection of patients at risk of vascular events.

摘要

目的

评估 BS 患者,尤其是有血管表现的患者的微循环异常及其临床相关性。

方法

采用甲襞微循环视频检查(NVC)进行横断面研究,以评估 BS 患者的微循环。

结果

共纳入 65 例患者。其中 34 例(52.3%)为男性,84.6%为欧洲白种人。24 例(36.9%)存在血管受累。47.7%的患者 NVC 存在定性异常。最常见的是扭曲和分支毛细血管(21.5%),其次是微出血(12.3%)、毛细血管扩大(7.7%)和巨毛细血管(3.1%)。我们发现,扭曲和分支毛细血管的存在与先前的浅表血栓性静脉炎(ST)之间存在显著关系(p=0.025)。NVC 中存在≥2 种定性异常与血管受累相关(p=0.031),主要与静脉血栓形成事件相关(p=0.024),尤其是与 ST 相关(p=0.003)。未观察到特定的 Cutolo 模式。NVC 与雷诺现象或 ANA 之间无关联,但 ANA 阳性的患者更常出现非特异性毛细血管异常(p=0.003)。

结论

NVC 中存在≥2 种定性异常与 Vasculo-Behçet 相关。NVC 可能是早期发现易发生血管事件的患者的潜在工具。

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