Association between nail-fold capillary findings and disease activity in dermatomyositis
Association between nail-fold capillary findings and disease activity in dermatomyositis
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DOI：
10.1093/rheumatology/keq430
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发表时间：
2011-06-01
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
客观的。尽管 SSc 患者的甲襞毛细血管变化和红细胞速度降低的发现已得到充分证实，但针对成人发病的 DM 患者的研究却很少。我们的目的是使用甲襞视频毛细血管镜检查 (NVC) 评估成人发病的 DM 患者的指甲襞毛细血管的变化和红细胞速度。方法。这项研究包括 50 名成人发病的 DM 患者和 20 名健康受试者。使用半定量评定量表对毛细血管镜检查的变化进行评分。使用逐帧测定毛细血管血浆间隙的位置来评估红细胞速度。结果。三十七名 (74%) 患者表现出硬皮病 NVC 模式。患有硬皮病模式的患者更频繁地表现出血清肌酸激酶水平升高，并且肌肉疾病活动的视觉模拟量表增加。毛细血管损失的分数与肌肉和全身疾病活动相关，而出血的分数与皮肤疾病活动相关。然而，NVC 结果与肺部受累没有显着相关性。通过治疗使疾病活动稳定后，不规则扩大的毛细血管、出血和毛细血管损失的评分减少。与健康对照相比，DM 患者的平均红细胞速度没有显着降低，并且治疗也没有改变。结论。我们的结果表明，甲襞毛细血管的变化反映了糖尿病的疾病活动性。此外，红细胞速度的差异可能反映了 DM 和 SSc 中不同程度的微循环损伤。
Objective. Although findings of nail-fold capillary changes and reduced red blood cell velocity in SSc patients are well established, studies in adult-onset DM patients are scarce. Our objective was to assess the changes and red blood cell velocity in finger nail-fold capillaries using nail-fold video capillaroscopy (NVC) in patients with adult-onset DM.Methods. This study included 50 patients with adult-onset DM and 20 healthy subjects. A semi-quantitative rating scale was used to score capillaroscopy changes. Red blood cell velocity was evaluated using frame-to-frame determination of the position of capillary plasma gaps.Results. Thirty-seven (74%) patients showed the scleroderma NVC pattern. Patients with the scleroderma pattern exhibited elevated serum creatine kinase levels more frequently and increased visual analogue scale of muscle disease activity. Scores of loss of capillaries were associated with muscle and global disease activity, whereas scores of haemorrhages were associated with skin disease activity. However, NVC findings were not significantly associated with lung involvement. The scores of irregularly enlarged capillaries, haemorrhages and loss of capillaries were reduced after stabilization of disease activity by treatment. The mean red blood cell velocity was not significantly reduced in DM patients compared with healthy controls and was not changed by treatment.Conclusion. Our results suggest that changes in nail-fold capillaries reflect disease activity in DM. Furthermore, the differences found in red blood cell velocity may reflect somewhat distinct microcirculation injuries in DM and SSc.