Objective To explore the correlation between nailfold capillary with clinical manifes-tation and laboratory test indicators in patients with rheumatoid arthritis(RA). Methods Eighty-three patients with RA were selected as RA group and 91 healthy examiners were selected as control group. Examinations of nailfold capillary on the ring finger of left hand were conducted in two groups and their results were compared. Patients with RA were divided into two groups according to with or without interstitial lung disease(ILD),with or without hand joints involved,number of joints involved and results of antinu-clear antibody(ANA)test,then composition ratio of patients with abnormal nailfold microcirculation were compared between each subgroup. Correlations between nailfold capillary and ILD,hand joints involved, number of joints involved,positive ANA,rheumatoid factor (RF ),28 joint disease activity scores (DAS28)-erythrocyte sedimentation rate(ESR),ESR,C-reactive protein(CRP),anti-cyclic citrullinated peptide antibody (ACP),course of disease and age were analyzed. Results Total score,morphology score,flow score,loops score of nailfold capillary and ratios of patietns whose morphological characteristics of nailfold capillary were cross-vessels,twisted vasospasm,plexus-like blood vessels,vasospasm of isolated enlargement,vasospasm of uniform enlargement,narrowing tube stenosis,number of sputum increasing,nipple venous plexus in RA group were significantly higher than those in control group(P＜0. 05). Ratios of patietns with abnormal nailfold microcirculation and total score of nailfold microcirculation were significantly higher than those in non-ILD group (P ＜0. 05 ). Abnormal nailfold microcirculation of patients with RA was positively correlated with ILD (Phi ＝0. 231,P ＝0. 036 ). Total score of nailfold microcirculation in patients with RA was positively correlated with RF(r＝0. 411,P＜0. 001). Conclusion There are some nonspecific changes of nailfold capillary in patients with RA. Abnormal nailfold capillary may be a predictor of RA extrarticular manifestations,especially ILD.%目的 探讨类风湿关节炎(RA)患者甲襞微循环变化与临床表现及实验室检查指标的相关性.方法 选择83例RA患者作为RA组,91例健康体检者作为对照组.两组患者均行左手无名指甲襞微循环检查并比较其结果 .根据是否合并间质性肺病(ILD)、有无手关节受累、关节受累数量是否＞3个及抗核抗体(ANA)检查结果 将RA患者进行分组,比较各亚组甲襞微循环异常患者构成比,并分析甲襞微循环与 ILD、手关节受累、关节受累数量、ANA阳性、类风湿因子(RF)、28个关节疾病活动评分(DAS28)-红细胞沉降率(ESR)、ESR、C反应蛋白(CRP)、抗环瓜氨酸肽抗体(ACP)、病程及年龄的相关性.结果 RA组甲襞微循环总积分、形态积分、流态积分、袢周积分、甲襞微循环形态学特征表现为交叉血管、扭曲血管袢、丛样血管、孤立增大血管袢、均匀增大血管袢、管袢变窄、管袢数量增多、乳头下静脉丛的患者比例均高于对照组(P＜0. 05).ILD组甲襞微循环异常患者比例和甲襞微循环总积分高于无ILD组(P＜0. 05).RA患者甲襞微循环异常与ILD呈正相关(Phi＝0. 231,P＝0. 036).RA患者的甲襞微循环总积分与RF呈正相关(r＝0. 411, P＜0. 001).结论 RA患者的甲襞微循环呈现一些非特异性改变,甲襞微循环异常可能是RA关节外表现特别是ILD的预测因素.
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