背景:慢性阻塞性肺疾病(COPD)在普通人群中发病率较高,所以早期识别和预防是目标。COPD发展的机制尚未完全确定,尽管已经证明内皮功能障碍起着重要作用。然而,到目前为止,内皮功能障碍的测量仍然是侵入性的或尚未完全建立。甲折视频毛细管镜检查(NVC)是一种安全的,非侵入性诊断工具,可用于轻松评估微循环,并可在早期显示任何可能的内皮功能障碍。这篇综述的目的是评估甲皱微循环异常是否可以反映肺血管系统的改变,并可以预测COPD患者心血管合并症的风险。
方法:在电子数据库中进行了有关COPD的系统文献检索(PUBMED,UpToDate,谷歌学者,ResearchGate),辅以手工研究。我们在这些数据库中搜索了直到2024年3月发表的文章。在数据库中以所有可能的组合搜索以下搜索词:慢性阻塞性肺疾病(COPD),内皮损伤,血管损伤,功能评估,毛细血管镜检查,视频毛细管镜检查,甲折视频毛细管镜检查。这篇评论只考虑了用英语写的手稿。仅在能够定义COPD与内皮功能障碍之间的关系时,才包括论文。
结果:搜索选择了10篇文章,其中,只有三个以前的评论可用。视网膜血管成像,流动介导的扩张(FMD),据报道,皮肤自发荧光(AF)是评估COPD患者内皮功能障碍的最有价值的方法。
结论:据推测,一氧化氮(NO)水平降低会导致COPD患者的微血管损伤。这一发现使我们能够假设NVC在COPD患者中的潜在有效性。然而,这种潜在的联系是基于假设;需要进一步的调查来证实这一假设.
BACKGROUND: Chronic obstructive pulmonary disease (COPD) has higher rates among the general population, so early identification and prevention is the goal. The mechanisms of COPD development have not been completely established, although it has been demonstrated that endothelial dysfunction plays an important role. However, to date, the measurement of endothelial dysfunction is still invasive or not fully established. Nailfold video capillaroscopy (NVC) is a safe, non-invasive diagnostic tool that can be used to easily evaluate the microcirculation and can show any possible endothelial dysfunctions early on. The aim of this review is to evaluate if nailfold microcirculation abnormalities can reflect altered pulmonary vasculature and can predict the risk of cardiovascular comorbidities in COPD patients.
METHODS: A systematic literature search concerning COPD was performed in electronic databases (PUBMED, UpToDate, Google Scholar, ResearchGate), supplemented with manual research. We searched in these databases for articles published until March 2024. The following search words were searched in the databases in all possible combinations: chronic obstructive pulmonary disease (COPD), endothelial damage, vascular impairment, functional evaluation, capillaroscopy, video capillaroscopy, nailfold video capillaroscopy. Only manuscripts written in English were considered for this review. Papers were included only if they were able to define a relationship between COPD and endothelium dysfunction.
RESULTS: The search selected 10 articles, and among these, only three previous reviews were available. Retinal vessel imaging, flow-mediated dilation (FMD), and skin autofluorescence (AF) are reported as the most valuable methods for assessing endothelial dysfunction in COPD patients.
CONCLUSIONS: It has been assumed that decreased nitric oxide (NO) levels leads to microvascular damage in COPD patients. This finding allows us to assume NVC\'s potential effectiveness in COPD patients. However, this potential link is based on assumption; further investigations are needed to confirm this hypothesis.