一项阿根廷的研究:系统性硬化病患者甲周毛细血管显微镜检查“晚期”改变与“早期/活动期”改变的脏器受累情况比较
译者:高文琴 校对:庞宇洁 审核:张莉芸
Abstract:Changes in nailfold capillaroscopy in systemic sclerosis patients could be related to the disease severity. The aim of this study was to investigate whether patients with "late" scleroderma (SD) pattern have more organ involvement than patients with "early/active" SD pattern. Forty-six Argentinian patients (44 women and 2 men), with a diagnosis of systemic sclerosis, were distributed in two groups -d on the presence of late and early/active patterns. Organ involvement was assessed as follows: pulmonary function by chest radiography, high-resolution chest tomography (HRCT), lung volume tests, and diffusing capacity for carbon monoxide (DLCO); esophageal involvement by manometry;and pulmonary arterial hypertension (PAH) by Doppler echocardiography and six-minute walk test. Honeycombing of the lungs evaluated by HRCT was more frequently present in patients with late pattern compared with early/active patients (p=0.01). We also found statistically significant differences in lung volume tests (p=0.03) and DLCO (p = 0.02) between the two SD pattern groups. Esophageal manometry showed a significantly higher frequency of motility disorders in the group with late pattern (p = 0.0024). In this study, patients with late pattern had higher frequency of pulmonary and esophageal involvement compared with patients with early/active pattern.
摘要:系统性硬化病患者甲周毛细血管改变可能与该疾病的严重程度有关。本研究的目的是探究甲周毛细血管“晚期”硬皮样(SD)改变的患者是否比“早期/活动期”SD改变的患者有更多的脏器受累。选取46例确诊为系统性硬化病的阿根廷患者(女性44例和男性2例),根据晚期和早期/活动期改变表现分为两组。脏器受累情况按如下方法评估:胸片、高分辨率胸部断层扫描(HRCT)、肺活量、CO弥散量评估肺功能;食管测压明确食道受累情况;多普勒超声心动图及六分钟步行试验明确肺动脉高压(PAH)情况。与早期/活动期的患者相比,HRCT发现肺部蜂窝状改变更多地出现在晚期患者(P=0.01)。我们还发现两组SD改变之间肺活量差异(P=0.03)和CO弥散量差异(P =0.02)均有统计学意义。食管测压显示,晚期改变患者食道运动障碍出现频率较高(P=0.0024)。在这项研究中,甲周毛细血管晚期改变患者出现肺和食管受累的频率比早期/活动期患者高。
引自:Marino Claverie L, Knobel E, Takashima L, etc.Organ involvement in Argentinian systemic sclerosis patients with "late" pattern as compared to patients with "early/active" pattern by nailfold capillaroscopy. Clin Rheumatol. 2013 Jun; 32(6): 839-843.