多普勒血流仪 ：儿童局限性硬皮病的诊断工具
Laser Doppler flowmetry as an assessment technique for localized scleroderma in childrenLocalized scleroderma is a rare connective tissue disorder characterized by hardening and thickening of the skin due to increased collagen density. A quarter of patients affected also experience muscle and bone involvement. Methods to detect active lesions and monitor therapeutic efficacy are unreliable; although helpful to some degree, infrared thermography often yields false-positive results. Laser Doppler flowmetry (LDF), a noninvasive method that measures cutaneous microcirculation, might be useful.
Weibel et al. compared the ability of LDF with that of infrared thermography to distinguish disease activity in 111 lesions from 41 children with localized scleroderma. All children underwent clinical examination, LDF, and thermography on two separate occasions. Seventy-five (34%) lesions were clinically confirmed as being active and 147 (66%) lesions as being inactive. A relative difference of 39% in blood flow and an absolute difference of 0.5 °C in temperature were cutoff values for increased disease activity.
Median blood flow was increased by 89% in active lesions, compared with 11% in inactive lesions (P <0.001). The corresponding median increases in temperature were 0.5 °C and 0.3°C, respectively (P = 0.024). Sensitivity values for LDF and thermography were 80% and 52%, and specificity values were 77% and 58%, respectively.
The authors conclude that LDF has diagnostic value because it can clearly and accurately distinguish active from inactive lesions. Further research into the ability of this method to monitor response to treatment is being performed.
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