系统性红斑狼疮患者甲襞微循环与临床表现及临床指标的相关性分析

The correlation between nailfold microcirculation and clinical manifestation in patients with systemic lupus erythematosus

目的探讨系统性红斑狼疮(SLE)患者的甲襞微循环与临床表现及相关指标之间的关系。方法选取2011年1月—2014年12月诊治的SLE患者53例为观察组,选择同期健康志愿者50例为健康对照组,对所有入选对象进行甲襞微循环检查,比较2组甲襞微循环积分差异;记录SLE患者的临床表现,比较伴与不伴肺间质病变(ILD)、肺动脉高压(PAH)、雷诺现象(RP)以及皮疹患者间甲襞微循环积分差异,分析其与SLE患者甲襞微循环积分之间的相关性。结果与健康对照组比较,观察组患者甲襞微循环形态积分、流态积分、袢周积分和总积分均显著升高(t=12.992、11.410、7.926、12.233,P<0.05);伴ILD和PAH的SLE患者甲襞微循环形态积分、流态积分、袢周积分和总积分与不伴ILD和PAH的SLE患者相比,差异均无统计学意义(P>0.05);伴RP的SLE患者甲襞微循环形态积分、流态积分、袢周积分和总积分显著高于不伴RP的SLE患者(￡=4.602、3.981、4.244、3.099,P<0.05);伴皮疹的SLE患者甲襞微循环形态积分和总积分显著高于不伴皮疹的SLE患者(t=3.794、2.865,P<0.05),流态积分和袢周积分比较差异无统计学意义(t=1.413、0.617,P>0.05);SLE患者甲襞微循环总积分与年龄呈正相关(r=0.852,P<0.05),与C_3、C4、CRP、ESR、PLT、WBC、IgG和尿蛋白等均无相关性。结论 SLE患者存在一定程度的甲襞微循环异常,伴发ILD、PAH、RP和皮疹等可能加重甲襞微循环异常程度,因此临床上对SLE患者行甲襞微循环检查有助于病情的诊断。

Objective To investigate the relationship between microeirculation and clinical manifestations in patients with systemic lupus erythematosus （SLE）. Methods From January 2011 to December 2014, 53 SLE patients were enrolled as the observation group, 50 cases of healthy volunteers over the same period enrolled as the healthy control group, all selected subjects underwent microcirculation inspection, microcirculation points difference were compared between the two groups; clinical manifestations of SLE patients were recorded, and compared microcirculation Points difference in patients with and without interstitial lung disease （ ILD）, pulmonary arterial hypertension （PAH） , Raynaud＇s phenomenon （RP） and skin rash; recorded the clinical parameters in patients with SLE, observed correlation between these indexes and nailfold microcir- culation. Results Compared with the healthy control group, the observation group＇ s integral nail fold microeireulation mor- phology, flow pattern points, loop circumference and total score were significantly increased （ t = 12. 992, t = 11. 410, t = 7. 926, t = 12. 233, P 〈 0.05 ） ; naiffold microcirculation morphology score, integral flow pattern, loop circumference and to- tal score in ILD and PAH in SLE patients with and without ILD and PAH did not show statistically significant difference （ P 〉 0.05 ） ; mierocirculation morphology score, integral flow pattern, loop circumference and total score in SLE patients with RP was significantly higher than that of SLE patients without RP （ t = 4. 602, t = 3. 981, t = 4. 244, t = 3. 099, P 〈 O. 05 ） ; SLE patients with rash＇ s microcireulation morphology and total score was significantly higher than that of SLE patients without rash （ t = 3. 794, t = 2. 865, P 〈 0.05 ）, flow pattern points and loop points＇ difference was not statistically significant （ t = 1. 413, t =0. 617, P 〉 0.05） ; SLE patients＇ microcirculation total score was positively correlated with age （ r = 0. 852, P 〈 0.05）, and had no correlation with C3, C4, CRP, ESR, PLT, WBC, IgG, and urinary protein. Conclusion It demon- strated that the SLE patients had a certain degree of microcirculation abnormalities ,aggravate the degree of abnormality of micro-circulation associated with ILD, PAH, RP and rash, so the microcirculation examination can help to observe the progression of the disease.