译者：高文琴 校对：庞宇洁审核：张莉芸

Abstract：-IVE:Thisstudyevaluatespossiblecorrelationsbetweenthepatternofantinuclearantibodies(ANA)onindirectimmunofluorescence(IIF)testingandnailfoldmicroangiopathystage(early,active,andlatestage)insystemicsclerosis(SSc).PatientswithSScwerefollowedprospectivelytomonitorprogressionofmicrovasculardamage.METHODS:TheANApatternonIIFwassearchedin42patientswithSScshowinganearlypatternofnailfoldmicroangiopathyat-line,andwasfollowedusingnailfoldvideocapillaroscopy(NVC)foramediantimeof91months.RESULTS:AmongpatientswhosemicroangiopathyshowedarapidprogressionfromearlytolatepatternonNVC,theIIFpatternwasfine-speckled+nucleolar(Scl-70+)in44%,centromericin33%,nucleolarin11%,andhomogeneousin11%ofpatientswithSSc.AntitopoisomeraseIantibodiesweresignificantlymorefrequent(57%)inpatientswithlatepatternofmicroangiopathyonNVC.Themediantimeofprogressionfromearlytoactivediseasewassignificantlylowerinpatientswithbothfine-speckled+nucleolarandnucleolarANApositivity.TheseverityofmicroangiopathywashigherinpatientswiththenucleolarpatternonIIF.Patientsalreadyshowingaslightreductionofcapillarynumberat-linewerelikelytohaveeitherthenucleolarorthefine-speckled+nucleolarpatternonIIF.Ofnote,37%ofpatientsstillshowingtheearlymicroangiopathypatternonNVCattheendofthefollowupwereANA-negative.CONCLUSION:ANA-negativepatientswithSScdisplayaslowerprogressionofnailfoldmicroangiopathycharacterizedbytheearlypatternonNVC.ProgressiontothelateNVCpattern(moreadvancedstageofmicrovasculardamage)seemstobeassociatedwithadifferentautoantibodypatternonIIF(fine-speckled+nucleolarpatternbeingthemostprevalent).

摘要：目的：本研究旨在探讨系统性硬化病（SSc））抗核抗体（ANA）（间接免疫荧光法检测）和甲襞微血管病变程度（早期，活动期，晚期）之间可能的相关性。本研究是一项随访SSc患者微血管损伤进展的前瞻性研究。方法：选取42名基线甲襞微血管病变为早期改变的SSc患者，间接免疫荧光法检测ANA核型，甲襞微循环检查（NVC）随访91个月。结果：甲襞微血管病变由早期快速进展到晚期的患者中，间接免疫荧光结果：44％为斑点型+核仁型（SCL-70+），33％为着丝点型，11％为核仁型，11％均质型。抗拓扑异构酶Ⅰ抗体更多见于甲襞微循环晚期改变的患者（57％）。ANA斑点型+核仁型和核仁型的患者甲襞微循环由早期进展到活动期的时间显著缩短。ANA核仁型患者微血管病变的程度更重。基线水平已经有轻微毛细血管数减少的患者，间接免疫荧光结果可能为核仁型或斑点型+核仁型。值得注意的是，在随访结束时有37％的患者甲襞微循环一直表现为早期改变，这部分患者ANA为阴性。结论：ANA阴性、甲襞微循环为早期改变的SSc患者甲襞微血管病变进展较为缓慢。发展到甲襞微循环晚期改变（微血管损伤晚期阶段）的患者，似乎与不同的ANA核型相关（斑点型+核仁型最为普遍）。

引自：SulliA1, RuaroB, SmithV,et al.Progressionofnailfoldmicrovasculardamageandantinuclearantibodypatterninsystemicsclerosis.JRheumatol. 2013May;40(5):634-639.

此文章内容仅代表医生观点，仅供参考。涉及用药、治疗等问题请到当地医院就诊，谨遵医嘱！