显著的指甲毛细血管损失和晚期毛细血管显微图案与系统性硬化症中的肺动脉高血压有关
Rossella De Angelis1, Valeria Riccieri2, Edoardo Cipolletta1
1Rheumatology Unit, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
Rheumatology (Oxford, England)
|August 25, 2023
概括
患有全身性硬化症和肺动脉高血压 (SSc-PAH) 的患者表现出更严重的指甲视频毛细管学 (NVC) 异常,包括毛细管损失和无血管区域. 这些NVC发现可能有助于预测SSc患者的PAH诊断.
科学领域:
- 类风湿病学 类风湿病学
- 心脏病学 心脏病学
- 血管生物学 血管生物学
背景情况:
- 系统性硬化症 (SSc) 是一种结缔组织疾病,其特征是微血管异常.
- 肺动脉高血压 (PAH) 是SSc的严重并发症,需要早期诊断.
- 爪视频毛囊显微镜 (NVC) 是一种评估外周微循环的非侵入性技术.
研究的目的:
- 调查指甲视频毛囊镜 (NVC) 的特定发现,使SSc患者与无肺动脉高血压 (PAH) 患者有区别.
- 确定NVC模式是否可以作为SSc.中PAH的预测标记.
主要方法:
- 一项涉及110名SSc患者的横截面病例控制研究,分为SSc-PAH (通过右心导管检查确认) 和SSc-非PAH组.
- 使用半定量评分系统评估NVC模式 (早期,活跃,晚期) 和形态参数 (毛细血管密度,异常,微出血,无血管区域).
- 采用多变量分析来确定SSc-PAH的独立预测因子.
主要成果:
- 与SSc-PAH患者相比,SSc-non-PAH患者的晚期NVC模式,非特异性异常,较低的毛细血管密度和较大的无血管区域的频率更高.
- 多变量分析显示,非特异性异常,毛细血管密度降低和无血管区域与SSc-PAH显著相关.
- 平均肺动脉压和NVC参数 (如无血管区域,毛细血管密度和非特异性异常) 之间观察到相关性.
结论:
- 独特的外周微循环损伤,包括毛细血管损失和形态异常,在患有PAH的SSc患者中更为明显.
- NVC发现,特别是毛细血管损失和特定的形态变化,是有价值的指标,可以潜在地预测SSc患者的PAH.
- 将NVC变量集成到临床模型中可以提高SSc人群中PAH的诊断准确性.
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