Reduced red blood cell velocity in nail-fold capillaries as a sensitive and specific indicator of microcirculation injury in systemic sclerosis
Reduced red blood cell velocity in nail-fold capillaries as a sensitive and specific indicator of microcirculation injury in systemic sclerosis
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DOI：
10.1093/rheumatology/kep066
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发表时间：
2009-06-01
期刊：
影响因子：
5.5
通讯作者：
Takehara, Kazuhiko
中科院分区：
文献类型：
--
作者：
Mugii, Naoki;Hasegawa, Minoru;Takehara, Kazuhiko
Objective.采用视频毛细血管镜检查评估SSc和其他胶原疾病患者的指甲襞毛细血管中红细胞速度。本研究包括127例SSc患者以及SLE（n 33）、DM/PM（n 21）、RA（n 13）和APS（n 12）患者和20例健康受试者。红细胞流速通过帧间测定毛细血管血浆间隙的位置来评估。与健康对照组（降低63.0）和其他疾病患者相比，SSc患者的平均红细胞速度显著降低。dcSSc和lcSSc患者的平均血流速度相似。重要的是，即使是具有正常或非特异性甲襞视频毛细血管镜（NVC）模式或硬皮病早期NVC模式的SSc患者，与健康对照组（分别减少51.7和61.4）或具有其他疾病的患者相比，尽管毛细血管变化正常或轻微，红细胞速度也显着降低。硬皮病活动期和晚期NVC型患者的血流速度下降更明显（分别降低65.5和66.2）。这种血流速度的降低与NVC的发现显著相关，包括毛细血管分支和毛细血管损失。虽然在患有顽固性手指溃疡的SSc患者中观察到速度显著降低（减少72.1），但通过脂质体前列腺素E-1（lipo-PGE（1））输注可显著改善。我们的研究结果表明，血液流速降低是SSc的一个标志。此外，红细胞流速的测量可能有助于评价微循环的治疗效果。
Objective. To assess red blood cell velocity in finger nail-fold capillaries using video capillaroscopy in patients with SSc and other collagen diseases.Methods. This study included 127 patients with SSc as well as patients with SLE (n 33), DM/PM (n 21), RA (n 13) and APS (n 12), and 20 healthy subjects. Red blood cell velocity was evaluated using frame-to-frame determination of the position of capillary plasma gaps.Results. The mean red blood cell velocity was significantly decreased in patients with SSc compared to healthy controls (63.0 reduction) and patients with other conditions. Mean blood velocity was similar between patients with dcSSc and lcSSc. Importantly, even SSc patients with normal or non-specific nail-fold video capillaroscopic (NVC) patterns or a scleroderma early NVC pattern exhibited a significantly lower red blood cell velocity compared to healthy controls (51.7 and 61.4 reduction, respectively) or patients with other conditions, despite normal or mild capillary changes. Patients with the scleroderma active and late NVC pattern showed a more decreased blood velocity (65.5 and 66.2 reduction, respectively). This reduced blood velocity was significantly associated with NVC findings, including capillary ramification and capillary loss. Although remarkably reduced velocity was observed in SSc patients with intractable digital ulcers (72.1 reduction), it was significantly improved by lipo-prostaglandin E-1 (lipo-PGE(1)) infusion.Conclusion. Our results suggest that reduced blood velocity is a hallmark of SSc. Furthermore, measurement of red blood cell velocity may be useful in evaluating therapeutic effects on microcirculation.