Page 64 - 《南京医科大学学报（自然科学版）》2025年第9期

南京医科大学学报（自然科学版） 第45卷第9期
·1276 · Journal of Nanjing Medical University（Natural Sciences） 2025年9月

·临床研究·

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

周张迪 ，张译心 ，戴嘉懿 ，李东玉 ，孙晓萱 ，王 嫱 1*
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南京医科大学第一附属医院风湿免疫科，心血管内科，江苏 南京 210029
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［摘 要］ 目的：本研究旨在评估甲襞微循环检测（nailfold video capillaroscopy，NVC）在结缔组织病（connective tissue disease，
CTD）相关肺动脉高压（pulmonary arterial hypertension，PAH）患者诊断中的预测价值。方法：回顾性分析2022年9月—2024年6
月在南京医科大学第一附属医院风湿免疫科住院并行NVC的CTD患者147例。根据是否合并PAH，将患者分为CTD⁃PAH和
CTD⁃nonPAH 两组。通过多因素Logistic 回归分析筛选CTD患者发生PAH的危险因素。基于该多因素Logistic 回归分析构建
Nomogram预测模型，并使用受试者工作特征曲线（receiver operating characteristic，ROC）进行模型性能评估。结果：CTD患者中
CTD⁃PAH 组 52 例（35.4%）。CTD⁃PAH 组患者的毛细血管袢长度较 CTD⁃nonPAH 组长［262.0（207.0，308.0）vs. 202.0（160.0，
272.0），P < 0.05］，袢周积分高于 CTD⁃nonPAH 组［2.40（0.80，3.92）vs. 1.90（0.40，2.80），P < 0.05］。Logistic 回归分析显示管袢
长度长和袢周积分高均增加PAH 发生的风险［OR=1.300（95%CI：1.100~1.500），OR=1.268（95%CI：1.025~1.568）］。Nomogram
预测模型ROC曲线下面积达0.705（95%CI：0.618~0.792，P < 0.05）。结论：甲襞毛细血管特征（包括毛细血管袢长度和袢周积分）
可能是结缔组织病患者发生肺动脉高压的独立预测因子，为CTD⁃PAH患者的早期筛查和个体化治疗策略提供了新的依据。
［关键词］ 肺动脉高压；结缔组织病；甲襞微循环检测；微循环
［中图分类号］ R544.1；R593.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2025）09⁃1276⁃10
doi：10.7655/NYDXBNSN241263

Exploring the risk of pulmonary arterial hypertension in patients with connective tissue
disease based on nailfold video capillaroscopy

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ZHOU Zhangdi ，ZHANG Yixin ，DAI Jiayi ，LI Dongyu ，SUN Xiaoxuan ，WANG Qiang 1*
1 Department of Rheumatology，Department of Cardiology，the First Affiliated Hospital with Nanjing Medical
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University，Nanjing 210029，China
［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

［基金项目］ 国家重点基础研究发展计划（2021YFC2501305）
通信作者（Corresponding author），E⁃mail：jerrytortoise@163.com（ORCID：0000⁃0002⁃3079⁃6383）
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