系统性硬化病患者甲周毛细血管显微镜检查异常为死亡的预测因素
译者:高文琴 校对:庞宇洁 审核:张莉芸
Abstract
-IVES:Peripheral microangiopathy is a hallmark of systemic sclerosis (SSc) and can be early detected by nailfold capillaroscopy (NFC). This study aimed to examine whether more severe peripheral microangiopathy at NFC are predictive factor for death in SSc patients.METHODS:135 SSc patients who performed NFC between June 2001 and July 2009 were included. The following NFC parameters were evaluated: number of capillary loops/mm, avascular score (scored from 0 to 3), and number of enlarged and giant capillary loops. Univariate and multivariate regression models were used to analyse the association of mortality with NFC and clinical parameters.RESULTS:At the time of the analysis (August 2010), 123 patients were alive, and 12 were dead. By univariate analysis, male gender, forced vital capacity 1.5 on NFC were associated with a significantly increase risk of death. By multivariate analysis, an avascular score >1.5 was the only independent predictor of death (hazard ratio 2.265). Survival rates from diagnosis at 1, 5 and 10 years were lower in patients with avascular score >1.5 (97%, 86%, and 59%, respectively) compared with those with avascular score ≤1.5 (97%, 97%, and 91% respectively) (p=0.009 by log rank test).CONCLUSIONS:Avascular scores higher than 1.5 at NFC was an independent predictor of death in SSc, suggesting that NFC can be useful for predicting SSc outcome.
摘要:目的:外周血管病变是系统性硬化病(SSc)的特征性改变,可以通过甲周毛细血管显微镜检查(NFC)及早发现。本研究旨在探究患者严重的NFC外周血管病变是否是SSc患者死亡的预测因子。方法:选取2001年6月到2009年7月之间行NFC的系统性硬化病患者135例。评估以下NFC参数:毛细血管数/毫米,缺血评分(得分从0到3分),扩张毛细血管和巨型毛细血管管袢数。单因素分析和多元回归分析死亡率与NFC和临床指标的相关性。结果:在分析期间(2010年8月),123例患者存活,12例死亡。单变量分析显示,男性、用力肺活量1.5的都显著增加SSc患者死亡风险。多变量分析显示,缺血评分> 1.5是SSc患者死亡的唯一独立预测因素(危险比2.265)。缺血得分> 1.5的患者1年、5年、10年生存率(分别为97%、86 %和59 %),而缺血得分≤1.5的患者生存率(分别为97 %、97 %、91%)低。(P=0.009对数秩检验)。结论:NFC缺血得分高于1.5是系统性硬化病患者死亡的独立预测因素。提示NFC可预测系统性硬化病患者的预后。
引自:Kayser C, Sekiyama JY, Próspero LC, etal. Nailfold capillaroscopy abnormalities as predictors of mortality in patients with systemic sclerosis.Clin Exp Rheumatol. 2013 Mar-Apr;31(2 Suppl 76):103-108.