The diagnostic significance of nailfold videocapillaroscopy in systemic sclerosis / 中华内科杂志

ABSTRACT

ObjectiveTo observe nailfold capillary changes in a cohort of conncctive tissue disease ( CTD ) with Raynaud's phenomenon (RP) and to explore the diagnostic value of nailfold videocapillaroscopy (NVC) in systemic sclerosis(SSc).MethodsSixty CTD patients with RP divided into SSc group (n =36) and non-SSc group ( n =24) were referred to an experienced operator for NVC.ResultsThe patients had decreased capillary loops in SSc group with the capillary diameter more enlarged in SSc group than nonSSc group.The number of patients in SSc group with giant capillaries was 14,while 3 in non-SSc group.There were 23 patients with haemorrhagcs in SSc group and 9 in non-SSc group.The number of patients with severe effusion was 15 in SSc group,while 2 in non-SSc group.By using the ROC curves,indexes with AUC at least 0.7 of the input capillary diameter,the output capillary diameter,the middle capillary diameter,blood color and effusion for the diagnostic cutoff points were 18.5 μm,24.5 μm,19.5μm,deep red and severe effusion.With at least 2 out of the top 3 indexes,the diagnostic sensitivity and specificity of SSc were higher.ConclusionsCTD Patients with RP of SSc have less capillary loops,more enlarged capillaries,more giant capillaries, moresevereeffusionandmorehaemorrhagesthannon-SScpatients. The characteristics of nailfold capillary changes in SSc patients with RP can be helpful tor the diagnosis and the differential diagnosis of SSc.