微血管损伤能否预测系统性硬化症患者的疾病严重程度？

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-08-01 DOI:10.1016/j.reuma.2024.05.004

Ana Martins , Sofia Pimenta , Daniela Oliveira , Raquel Miriam Ferreira , Miguel Bernardes , Lúcia Costa , Georgina Terroso

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引用次数: 0

摘要

导言系统性硬化症（SSc）的特征是皮肤和内脏器官进行性纤维化、微血管损伤以及细胞和体液免疫异常。材料与方法对确诊后 6 个月内接受过甲折视频脑底镜检查的系统性硬化症患者进行了一项回顾性研究。收集了发病头 3 年的内脏受累情况和 NVC 结果。根据 NVC 模式的恶化程度，将微血管损伤的严重程度分为四类。器官受累的严重程度由 Medsger 的疾病严重程度量表对每个器官进行评估，作为疾病严重程度的整体衡量标准，则采用简单求和法。微血管损伤的严重程度与疾病严重程度的总体衡量（r = 0.55，p = 0.001）、外周血管受累的严重程度（r = 0.43，p = 0.001）和皮肤受累的严重程度（r = 0.34，p = 0.001）之间存在中度相关性。在单变量分析中，NVC 中出现晚期硬皮病模式可预测数字溃疡（OR 6.03，95% CI 1.52-23.86，p = 0.01）、肌肉受累（OR 13.09，95% CI 1.09-156.78，p = 0.04）、钙化（OR 27.22，95% CI 5.56-133.33，p <0.001）和总体疾病严重程度评分恶化（OR 1.67，95% CI 1.17-2.38，p = 0.005）。根据病程和性别进行调整后的多变量分析证实，晚期模式是钙化的独立预测因素（OR 42.89，95% CI 5.53-332.85，p <0.001）。本研究强调了 NVC 作为预后工具的重要性，以及作为系统性内脏受累的可能预测因子的重要性。

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Can microvascular damage predict disease severity in patients with systemic sclerosis?

Introduction

Systemic sclerosis (SSc) is characterized by progressive fibrosis of the skin and internal organs, microvascular damage and cellular and humoral immunity abnormalities. Microvascular damage can be easily detected through nailfold videocapillaroscopy (NVC).

Materials and methods

A retrospective study of patients with SSc and a NVC performed within the first 6 months after diagnosis was conducted. Visceral involvement in the first 3 years of the disease and NVC findings were collected. The severity of microvascular damage was classified into four categories, according to the worsening of the NVC patterns. The severity of organ involvement was assessed by the disease severity scale of Medsger for each organ and as a global measure of disease severity, the simple summation was used.

Results

A total of 86 patients with SSc were included. A moderate correlation was found between the severity of microvascular damage and the global measure of disease severity (r = 0.55, p < 0.001), the severity of peripheral vascular involvement (r = 0.43, p < 0.001) and the severity of skin involvement (r = 0.34, p = 0.001).

The presence of a late scleroderma pattern in NVC were predictive in univariate analysis of digital ulcers (OR 6.03, 95% CI 1.52–23.86, p = 0.01), muscular involvement (OR 13.09, 95% CI 1.09–156.78, p = 0.04), calcinosis (OR 27.22, 95% CI 5.56–133.33, p < 0.001) and worse global disease severity score (OR 1.67, 95% CI 1.17–2.38, p = 0.005). Multivariate analysis adjusted for disease duration and gender confirmed late pattern as an independent predictor of calcinosis (OR 42.89, 95% CI 5.53–332.85, p < 0.001).

Discussion and conclusion

In this study, the worsening of NVC pattern in SSc was associated with the overall disease severity, the severity of peripheral vascular involvement and extension of skin involvement. This study highlights the importance of NVC as a prognostic tool and a possible predictor of systemic visceral involvement.

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.