CAJ | 학술논문

目的观察系统性硬化病( SSc)患者甲襞微循环的特点及其与其他结缔组织病(CTD)患者甲襞毛细血管镜下表现的差异.方法选取40例SSc患者和37例其他CTD的患者,所有患者均伴有雷诺现象,行甲襞毛细血管镜检查,比较SSc患者甲襞微循环各项指标与其他CTD患者之间的差异,并与疾病的临床和实验室参数进行相关分析,采用方差分析和t检验x2检验.结果 SSc患者甲襞微循环的主要特点是管袢数目减少,管袢扩张,畸形管袢增多,出现不同程度的皮下出血以及毛细血管新生等；SSc患者毛细血管镜的某些指标较其他CTD患者更严重,更具有特异性.伴有肺部或食管累及的SSc患者甲襞毛细血管镜总积分(肺部累及:13±5,食管累及:14±7)明显高于无上述器官累及者(无肺部累及:7±5,无食管累及:6±5,P＜0.01)；抗Scl-70抗体阳性的SSc患者甲襞毛细血管镜总积分明显高于抗体阴性组(14±9,6±5,P＜0.05).结论 SSc患者甲襞微循环表现具有特异性,甲襞微循环异常程度与临床免疫学指标有一定关系,提示毛细血管镜检查是评价SSc微血管病变的重要手段,可为鉴别SSc和其他CTD的提供参考意见,并可望作为评价疾病严重性的客观指标.
목적 관찰계통성경화병( SSc)환자갑벽미순배적특점급기여기타결체조직병(CTD)환자갑벽모세혈관경하표현적차이.방법 선취40례SSc환자화37례기타CTD적환자,소유환자균반유뢰낙현상,행갑벽모세혈관경검사,비교SSc환자갑벽미순배각항지표여기타CTD환자지간적차이,병여질병적림상화실험실삼수진행상관분석,채용방차분석화t검험x2검험.결과 SSc환자갑벽미순배적주요특점시관번수목감소,관번확장,기형관번증다,출현불동정도적피하출혈이급모세혈관신생등；SSc환자모세혈관경적모사지표교기타CTD환자경엄중,경구유특이성.반유폐부혹식관루급적SSc환자갑벽모세혈관경총적분(폐부루급:13±5,식관루급:14±7)명현고우무상술기관루급자(무폐부루급:7±5,무식관루급:6±5,P＜0.01)；항Scl-70항체양성적SSc환자갑벽모세혈관경총적분명현고우항체음성조(14±9,6±5,P＜0.05).결론 SSc환자갑벽미순배표현구유특이성,갑벽미순배이상정도여림상면역학지표유일정관계,제시모세혈관경검사시평개SSc미혈관병변적중요수단,가위감별SSc화기타CTD적제공삼고의견,병가망작위평개질병엄중성적객관지표.
Objective The aim of the study was to observe the features of nail fold microcirculation in systemic sclerosis (SSc) patients and to compare these findings in SSc patients with patients with other connective tissue diseases.Methods Forty patients with SSc and thirty-seven patients with other connective tissue diseases were included in the study and all the patients reported symptoms of Raynaud's phenomenon in the hands were also included.Nail fold capillaroscopy (NFC) was performed and the abnormality of nail fold microcirculation between the two groups were compared.The relations between nail fold capillaroscopic findings and clinicolaboratory parameters in SSc patients were analyzed.Statistical analysis were carried out by t-test and Chi-square.Results The loss of capillaries and dilated and giant capillaries and hemorrhage as well as neoangiogenesis were hallmarks of the scleroderma capillary findings,which could be detected by nail fold capillaroscopy.The abnormalities of nail fold microcirculation in SSc patients were more severe and more specific than those in other connective tissue disease patients.The total scores of nail fold capillaroscopy test were obviously higher in SSc patients with lung or esophagus involvement than those patients without these organ involvement,meanwhile,the total scores of nail fold capillaroscopic findiugs were elevated in SSc patients with anti-Scl70 antibody than those with negative group.Conclusion The nail fold capillaries of patients with SSc have specific abnormalities,and nail fold capill-aroscopy could distinguish between SSc and other connective tissue diseases,therefore it could be used as a promising tool for early detection of patients who may have the potential to develop scleroderma and it is also helpful in assessing disease severity.