甲襞视频毛细血管镜在SSc病情评估中的临床价值  

Clinical value of nailfold microcirculation microscope in disease evaluation of SSc

作　　者：李志[1] 张梦莹[1] 刘瑞韬 何倩 贾兰兰 强孚勇[1] Li Zhi;Zhang Mengying;Liu Ruitao;He Qian;Jia Lanlan;Qiang Fuyong(Yijishan Hospital of Wannan Medical College,Wuhu,Anhui 241001,China.)

机构地区：[1]皖南医学院弋矶山医院,安徽芜湖241001

出　　处：《齐齐哈尔医学院学报》2024年第6期567-570,共4页Journal of Qiqihar Medical University

基　　金：皖南医学院弋矶山医院三新项目(Y22052,Z22010)。

摘　　要：目的通过对系统性硬化症(SSc)患者进行甲襞视频毛细血管镜检查,探讨甲襞视频毛细血管镜在SSc患者病情评价中的价值。方法选择2022年1月—2023年4月在本院风湿科住院的23例系统性硬化症(SSc)患者(SSc组)和同期22名正常体检者(对照组)作为研究对象。比较两组甲襞微循环成像特征的差异,比较SSc患者发生合并症对甲襞微循环积分的影响。分析SSc患者甲襞微循环积分与疾病活动指标(血沉和IgG)的相关性。结果SSc组甲襞毛细血管在管袢扭曲、巨大管袢、乳头层萎缩及袢周渗出的发生率均高于对照组(P<0.05),而管袢密度及管袢长度均低于对照组(P<0.05)。SSc组在管袢输入支直径、袢顶直径、袢输出支直径及甲襞微循环积分均高于对照组(P<0.05),合并特异性抗体、雷诺现象、间质性肺病和肺动脉压高风险的SSc患者其甲襞微循环积分高于阴性患者(P<0.05);SSc患者甲襞微循环积分与血沉(r=0.724,P<0.01)及IgG(r=0.641,P<0.01)呈正相关。结论甲襞视频毛细血管镜检查有助于临床医师对SSc患者疾病活动性进行准确评估。Objective Through applying nailfold microcirculation microscopy in patients suffering from systemic sclerosis,to explore the value of nailfold microcirculation microscope in the disease evaluation of systemic sclerosis(SSc)patients.Methods Twenty-three SSc patients who were admitted to rheumatology department of the hospital from January 2022 to April 2023(SSc group)and 22 normal controls(control group)were enrolled in the study.The difference of nailfold microcirculation imaging characteristics between the two groups was compared,and the effect of comorbidities on nailfold microcirculation score in SSc patients was compared.The correlation between nailfold microcirculation score and disease activity indicators(erythrocyte sedimentation rate and IgG)in patients with SSc was analyzed.Results Compared with the control group,the SSc group had significantly higher incidence rates of twisted capillary loops,giant loops,atrophy of the papillary layer,and periloop exudation of nailfold capillaries(P<0.05),however,the significantly lower density and length of loops(P<0.05).Compared with the control group,the SSc group had significantly higher diameter of the the loop and nailfold microcirculation score(P<0.05),The nailfold microcirculation score of SSc patients had high risk in complicated with specific antibody,Raynaud's phenomenon,Interstitial lung disease and pulmonary artery pressure was higher than that of negative patients(P<0.05).The nailfold microcirculation score was positively correlated with ESR(r=0.724,P<0.01)and IgG(r=0.641,P<0.01)in SSc patients.Conclusions Nailfold microcirculation microscopy is helpful for clinicians to accurately assess the disease activity in patients with SSc.

关 键 词：系统性硬化症 甲襞毛细血管镜 微循环 

分 类 号：R593.2[医药卫生—内科学]