摘要 目的：通过一个系统性硬化症病人甲襞毛细血管损伤程度的中期纵向实验来研究其动态变化时间。

方法：使用甲襞毛细血管镜随访38个有早期硬皮式毛细血管病变的系统性硬皮病病人84个月（平均病程12个月）。

结果：甲襞毛细血管镜随访结束后发现，47%的病人仍停留在早期，34%处于活动期，13%处于晚期，而5%的病人恢复正常。从早期发展到活动期和从早期发展到晚期的病人他们病程发展的平均时间分别为（28±20）和 （36±29）个月。其中从早期发展到晚期的这一组病人从早期变化到活动期的平均时间仅有（8±1）个月(p=0.01)，这是毛细血管病变快速发展的一部分。除此之外有60%的病人出现了基于甲襞形态变化的临床症状。

结论：这个纵向研究的结果显示，约有一半的系统性硬皮病病人出现了毛细血管病变的动态变化并且一旦病人出现了从早期到活动期的快速变化（小于一年），那么就很有可能发展到有进一步临床表象的晚期，所以如有病人出现上述情况，我们应在临床中密切监测。

附原文 ：OBJECTIVE.: Performing a medium-term longitudinal study to investigate the timing of transition through different patterns of nailfold microvascular damage in patients with systemic sclerosis (SSc). METHODS.: Thirty-eight SSc patients (median disease duration 12 months) showing at baseline the "Early" scleroderma-pattern of microangiopathy were followed-up by nailfold videocapillaroscopy (NVC) for a median time of 84 months. RESULTS.: At the end of the follow-up, the NVC pattern was found still "Early" in 47%, "Active" in 34%, "Late" in 13%, and "Normal" in 5% of SSc patients. Mean time of progression from "Early" to "Active" and from "Early" to "Late" pattern was of 28±20 and 36±29 months, respectively. In the subgroup of patients whose microangiopathy progressed from "Early" to "Late" NVC pattern, the mean time of progression from "Early" to "Active" pattern was only 8±1 months (p=0.01), showing a subset of patients with fast progression of the microangiopathy. Clinical symptoms progressed according to the nailfold morphological changes in quite 60% of the SSc patients. CONCLUSIONS.: The results of this longitudinal study demonstrate a dynamic transition of the microvascular damage through different NVC patterns of microangiopathy in half of SSc patients. It is recommended that patients showing a rapid progression from "Early" to "Active" NVC pattern (less than one year) should be monitored closely since the evidence suggest they are at risk of rapid progression to the advanced ("Late") NVC pattern of microangiopathy that is associated with further SSc clinical manifestation.

引自：Sulli A, Pizzorni C, Smith V, Zampogna G, Ravera F, Cutolo M.Timing of transition between capillaroscopic patterns in systemic sclerosis.Arthritis Rheum， 2011 Nov 29. doi: 10.1002/art.33463. [Epub ahead of print]