南京医科大学学报（自然科学版）2025，Vol.45Issue(9)：1276-1285,10.DOI:10.7655/NYDXBNSN241263
基于甲襞微循环特征的结缔组织病患者肺动脉高压风险评估研究
Exploring the risk of pulmonary arterial hypertension in patients with connective tissue disease based on nailfold video capillaroscopy
摘要
Abstract
Objective:This study aims to evaluate the predictive value of nailfold capillaroscopy(NVC)in the diagnosis of patients with connective tissue disease(CTD)associated pulmonary arterial hypertension(PAH).Methods:A retrospective analysis was conducted on 147 patients with connective tissue disease(CTD)who were hospitalised in the Department of Rheumatology and Immunology of the First Affiliated Hospital with Nanjing Medical University and underwent NVC from September 2022 to June 2024.According to whether they were combined with pulmonary arterial hypertension(PAH)or not,CTD patients were divided into two groups:CTD-PAH and CTD-nonPAH.Risk factors for PAH in CTD patients were screened by multifactorial logistic regression analysis.A nomogram prediction model was constructed based on this multifactorial logistic regression analysis and the model performance was evaluated using the receiver operating characteristic(ROC)curve.Results:Among the CTD patients,52(35.4%)were included in the CTD-PAH group.The capillary length was longer in the CTD-PAH group than in the CTD-nonPAH group[262.0(207.0,308.0)vs.202.0(160.0,272.0),P<0.05],and the pericapillary score was higher than that in the CTD-nonPAH group[2.40(0.80,3.92)vs.1.90(0.40,2.80),P<0.05].Logistic regression analysis showed that both long capillary length and high pericapillary score increased the risk of PAH occurrence[OR=1.300(95%CI:1.100-1.500),OR=1.268(95%CI:1.025-1.568)].The area under the ROC curve of the nomogram prediction model amounted to 0.705(95%CI:0.618-0.792,P<0.05).Conclusion:The findings suggest that nailfold capillary characteristics,including capillary length and pericapillary score,may serve as independent predictors of PAH in patients with CTD.These results provide a new basis for early screening and individualized therapeutic strategies in CTD-PAH patients.关键词
肺动脉高压/结缔组织病/甲襞微循环检测/微循环Key words
pulmonary arterial hypertension/connective tissue diseases/nailfold video capillaroscopy/micro-circulation分类
医药卫生引用本文复制引用
周张迪,张译心,戴嘉懿,李东玉,孙晓萱,王嫱..基于甲襞微循环特征的结缔组织病患者肺动脉高压风险评估研究[J].南京医科大学学报（自然科学版）,2025,45(9):1276-1285,10.基金项目
国家重点基础研究发展计划(2021YFC2501305) （2021YFC2501305）
