Abstract：
BACKGROUND: Nailfold capillaroscopy has been used as a non-invasive diagnostic method for microvasculature evaluation in various rheumatological disorders. The present study aimed to determine the utility of nailfold capillaroscopy in the diagnosis of Kawasaki Disease (KD).
METHODS: In this case-control study nailfold capillaroscopy was performed in 31 patients with KD and 30 healthy controls. All nailfold images were evaluated for capillary distribution and capillary morphology such as enlargement, tortuosity, and dilatation of the capillaries.
RESULTS: Abnormal capillaroscopic diameter was identified in 21 patients from the KD group and 4 patients in the control group. The most common abnormality in capillary diameter was irregular dilatation in 11 (35.4%) KD patients and in 4 people (13.3%) in the control group. Distortions of the normal capillary architecture was commonly seen in the KD group (n=8). A positive correlation was observed between coronary involvement and abnormal capillaroscopic results (r=.65, P<.03). The sensitivity and specificity of capillaroscopy for the diagnosis of KD were 84.0% (95%CI: 63.9-95.5%) and 72.2% (95%CI: 54.8-85.8%), respectively. The PPV and NPV of capillaroscopy for KD were 67.7% (95%CI: 48.6-83.3) and 86.7% (95% CI: 69.3-96.2), respectively.
CONCLUSIONS: Capillary alterations are more common in KD patients compared to control group. Thus, nailfold capillaroscopy can be useful in detecting these alterations. Capillaroscopy is a sensitive test for detecting capillary alternations in KD patients. It could be used as a feasible diagnostic modality for evaluating microvascular damage in KD.
METHODS: In this case-control study nailfold capillaroscopy was performed in 31 patients with KD and 30 healthy controls. All nailfold images were evaluated for capillary distribution and capillary morphology such as enlargement, tortuosity, and dilatation of the capillaries.
RESULTS: Abnormal capillaroscopic diameter was identified in 21 patients from the KD group and 4 patients in the control group. The most common abnormality in capillary diameter was irregular dilatation in 11 (35.4%) KD patients and in 4 people (13.3%) in the control group. Distortions of the normal capillary architecture was commonly seen in the KD group (n=8). A positive correlation was observed between coronary involvement and abnormal capillaroscopic results (r=.65, P<.03). The sensitivity and specificity of capillaroscopy for the diagnosis of KD were 84.0% (95%CI: 63.9-95.5%) and 72.2% (95%CI: 54.8-85.8%), respectively. The PPV and NPV of capillaroscopy for KD were 67.7% (95%CI: 48.6-83.3) and 86.7% (95% CI: 69.3-96.2), respectively.
CONCLUSIONS: Capillary alterations are more common in KD patients compared to control group. Thus, nailfold capillaroscopy can be useful in detecting these alterations. Capillaroscopy is a sensitive test for detecting capillary alternations in KD patients. It could be used as a feasible diagnostic modality for evaluating microvascular damage in KD.
摘要：
背景：甲褶毛细血管镜检查已被用作各种风湿性疾病中微血管系统评估的非侵入性诊断方法。本研究旨在确定甲褶毛细血管镜检查在川崎病（KD）诊断中的实用性。
方法：在本病例对照研究中，对31例KD患者和30例健康对照者进行了甲褶毛细血管镜检查。对所有甲折图像进行毛细血管分布和毛细血管形态评估，如扩大，弯曲，和毛细血管扩张。
结果：在KD组21例患者和对照组4例患者中发现了异常的毛细管镜下直径。最常见的毛细血管直径异常是11例(35.4%)KD患者和4例(13.3%)对照组不规则扩张。正常毛细血管结构的扭曲在KD组中常见(n=8)。冠状动脉受累与异常毛细血管镜检查结果呈正相关(r=.65,P<.03)。毛细血管镜诊断KD的敏感性和特异性分别为84.0%(95CI:63.9-95.5%)和72.2%(95CI:54.8-85.8%),分别。KD的毛细血管镜检查的PPV和NPV分别为67.7％（95CI：48.6-83.3）和86.7％（95％CI：69.3-96.2），分别。
结论：与对照组相比，KD患者的毛细血管改变更为常见。因此，甲褶毛细管镜检查可用于检测这些改变。毛细血管镜检查是检测KD患者毛细血管交替的敏感测试。它可以作为评估KD微血管损伤的可行诊断方式。
方法：在本病例对照研究中，对31例KD患者和30例健康对照者进行了甲褶毛细血管镜检查。对所有甲折图像进行毛细血管分布和毛细血管形态评估，如扩大，弯曲，和毛细血管扩张。
结果：在KD组21例患者和对照组4例患者中发现了异常的毛细管镜下直径。最常见的毛细血管直径异常是11例(35.4%)KD患者和4例(13.3%)对照组不规则扩张。正常毛细血管结构的扭曲在KD组中常见(n=8)。冠状动脉受累与异常毛细血管镜检查结果呈正相关(r=.65,P<.03)。毛细血管镜诊断KD的敏感性和特异性分别为84.0%(95CI:63.9-95.5%)和72.2%(95CI:54.8-85.8%),分别。KD的毛细血管镜检查的PPV和NPV分别为67.7％（95CI：48.6-83.3）和86.7％（95％CI：69.3-96.2），分别。
结论：与对照组相比，KD患者的毛细血管改变更为常见。因此，甲褶毛细管镜检查可用于检测这些改变。毛细血管镜检查是检测KD患者毛细血管交替的敏感测试。它可以作为评估KD微血管损伤的可行诊断方式。
