Office capillaroscopy in systemic sclerosis
Office capillaroscopy in systemic sclerosis
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DOI：
10.1007/s10067-006-0489-6
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发表时间：
2007-08-01
影响因子：
3.4
通讯作者：
Taillefer, Suzanne
中科院分区：
文献类型：
--
作者：
Baron, Murray;Bell, Mary;Taillefer, Suzanne
本研究的目的是评估两种办公室技术，检眼镜和Dermlite (R)皮镜的可靠性，并检测系统性硬化症（SSc）的甲襞毛细血管镜异常。进行了两项独立的研究。在第一个实验中，四名风湿病学家用检眼镜检查了13名SSc患者和两名正常人的一只手上的两个手指的甲褶。在第二项研究中，6名风湿病学家用Dermlite (R)皮肤镜检查了6名SSc患者和2名正常人的每只手的两个手指的甲褶。在检眼镜研究中，由一名观察者进行了宽视场毛细血管显微镜检查，以评估有效性。检查人员确定每个手指上是否存在扩张袢、巨大毛细血管袢和/或无血管区。计算了kappa系数，证明了两者的一致性。使用检眼镜时，观察者间kappa系数分别为0.43、0.54和0.19；观察者之间的平均意见一致度分别为0.61、0.56和0.31；检、镜一致性分别为0.63、0.52和< 0.1，分别为毛细血管扩张区、巨毛细血管区和无血管区。使用皮肤镜时，观察者间信度kappa值分别为0.63、0.40和0.20；对于扩张毛细血管、巨毛细血管和无血管区域，观察者内信度分别为0.71、0.55和0.40。检眼镜和皮肤镜在检测巨大和扩张的毛细血管方面提供了中等到相当大的可靠性，但对于无血管区域，观察者之间的一致性很差。检眼镜是有效的，当比较显微镜检测巨大或扩张的毛细血管。我们得出结论，这些技术是检测SSc毛细血管异常的有用工具。
The aims of this study are to assess the reliability of two office techniques, the ophthalmoscope and the Dermlite (R) dermatoscope, and to detect nailfold capillaroscopy abnormalities in systemic sclerosis (SSc). Two separate studies were performed. In the first, the nailfolds of two fingers on one hand of 13 SSc patients and two normals were examined by four rheumatologists using an ophthalmoscope. In the second, the nailfolds of the two fingers of each hand of six SSc patients and two normals were examined by six rheumatologists with a Dermlite (R) dermatoscope. Widefield capillary microscopy was performed by one observer in the ophthalmoscope study to assess validity. The examiners determined the presence or absence of dilated loops, giant capillary loops, and/or avascular areas on each digit. The kappa coefficient was calculated to demonstrate agreement. With the ophtalmoscope, the inter-observer kappa coefficients were 0.43, 0.54, and 0.19; the average intra-observer agreements were 0.61, 0.56, and 0.31; and the ophthalmoscope-microscope agreement were 0.63, 0.52, and < 0.1 for dilated capillaries, giant capillaries, and avascular areas, respectively. With the dermatoscope, the kappa values for inter-observer reliability were 0.63, 0.40, and 0.20; and intra-observer reliability was 0.71, 0.55, and 0.40 for dilated capillaries, giant capillaries, and avascular areas, respectively. The ophthalmoscope and the dermatoscope provide moderate to substantial reliability to detect the presence of giant and dilated capillaries but poor inter-observer agreement for avascular areas. The ophthalmoscope is valid when compared to the microscope for detecting giant or dilated capillaries. We conclude that these techniques are useful office tools to detect capillary abnormalities in SSc.