摘要
目的:评价甲襞毛细血管镜检查(NVC)指标与系统性红斑狼疮(SLE)患者肺动脉高压(PAH)及心血管损害的相关性,分析NVC对预测SLE伴发PAH的价值。方法:经胸超声心动图检测46例SLE患者(SLE组)的肺动脉压(PAP),其中合并PAH患者17例(SLE-PAH组),无PAH患者29例(SLE-non-PAH组);依据是否伴发心血管并发症,将46例SLE患者分为SLE-无心血管损害组(n=30)和SLE-有心血管损害组(n=16)。另选10例健康人作为正常对照组。以毛细血管镜检测各组手指甲襞毛细血管的管袢数、管径、形态、血流、出血、红细胞聚集、血色等指标。免疫比浊法检测各组外周血血清补体C3、C4和免疫球蛋白IgG浓度,免疫荧光法检测血浆B型脑钠肽(BNP)水平。比较各指标组间差异,并分析NVC检查指标与患者免疫指标的相关性。结果:(1)SLE-PAH组患者毛细血管管袢数显著减少(P<0.05);(2)SLE-PAH组患者的毛细血管管径、形态、流速、红细胞聚集等异常评分显著升高;(3)SLE组患者各NVC异常与心血管并发症和血浆BNP浓度相关。结论:SLE患者甲襞微循环异常与其PAH及心血管损害包括心功能不全相关,可用来预测PAH的发生及预后。
Objective:To find out the significance of nailfold video capillaroscopy(NVC)on the prediction for pulmonary arterial hypertension(PAH)in patients with systemic lupus erythematosus(SLE)by estimating the correlation of the indexes of NVC with PAH and cardiovascular injury.Method:Transthoracic echocardiography(TTE)was performed to examine the pulmonary arterial pressure(PAP)in 46 cases with SLE.Among them,17 patients had PAH(SLE-PAH group)and 29 patients didn't have PAH(SLE-non-PAH group).According to whether accompanied by cardiovascular complications,46 SLE patients were divided into SLE-without cardiovascular complication group(n=30)and SLE-with cardiovascular complication group(n=16).Another 10 normal persons were selected as normal control group.NVC was utilized to test the fingers capillaries of these patients.The parameters of NVC were estimated including:loop number,loop diameter,loop morphology,blood flow,haemorrhage,blood color,et al.The levels of serum complement C3,C4 and immunoglobulin IgG were detected by immunoturbidimetry assay,and plasma B-type brain natriuretic peptide(BNP)level was quantitatively detected by immunofluorescence.The differences between the groups of NVC indexes were compared,and the correlation between NVC parameters and immune indexes of SLE patients was analyzed.Results:The number of capillary loops in patients with SLE-PAH was significantly decreased.The abnormal scores of capillary loop diameter,morphology,flowing speed and erythrocyte aggregation in SLE-PAH group were evidently higher than SLE-non-PAH group.The abnormal characters of NVC correlated with cardiovascular complications and the concentration of BNP in the plasma of SLE patients.Conclusion:The abnormality of nailfold microcirculation is related with the development of PAH and cardiovascular complications including cardiac failure in SLE patients.NVC can be utilized to predict the occurrence and prognosis of SLE-PAH.
作者
姜波
徐雪
王春
耿林玉
冯学兵
JIANG Bo;XU Xue;WANG Chun;GENG Lin-yu;FENG Xue-bing(Department of Rheumatology and Immunology,Gulou Hospital Affiliated to Medical College of Nanjing University,Nanjing 210008,China)
出处
《微循环学杂志》
2019年第3期21-25,共5页
Chinese Journal of Microcirculation
基金
南京市科技发展计划项目(201715021)
中华国际医学交流基金会先声临床科研专项基金(Z-2014-06-2-1863)
关键词
电子甲襞毛细血管镜
系统性红斑狼疮
肺动脉高压
Nailfold video capillaroscopy
Systemic lupus erythematosus
Pulmonary arterial hypertension
