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目的 探讨前列地尔注射液治疗结缔组织病所致雷诺现象的疗效及对患者甲襞微循环的影响.方法 选取结缔组织病患者52例,根据是否伴发雷诺现象分为无雷诺现象组(n=28)及伴雷诺现象组(n=24),另选取30例健康者为对照组,采用彩色微循环检测仪检测并比较各组甲襞毛细血管形态学特征及各甲襞微循环指标;伴雷诺现象组患者给予前列地尔注射液治疗,检测并比较治疗前后患者各甲襞微循环指标的变化.结果 与对照组比较,伴雷诺现象组及无雷诺现象组患者甲襞毛细血管形态积分、流态积分、袢周积分及总积分均显著升高,差异有统计学意义(P＜0.01),且伴雷诺现象组显著高于无雷诺现象组,差异有统计学意义(P＜0.01);与治疗前比较,治疗后伴雷诺现象组患者甲襞毛细血管形态积分、流态积分、袢周积分及总积分均显著降低,差异有统计学意义(P＜0.01),且治疗后伴雷诺现象组形态积分及袢周积分与对照组相比差异无统计学意义(P＞0.05),而流态积分及总积分仍显著高于对照组,差异有统计学意义(P＜0.0l).结论 甲襞微循环可作为结缔组织病所致雷诺现象患者的诊断及病情评估指标,且前列地尔注射液可有效改善患者甲襞微循环异常,疗效显著.“,”Objective To explore the clinical efficacy and the influence of alprostadil injection on the nailfold microcirculation in the Raynaud’s pheomenon associated with connective tissue disease.Methods Fifty-two patients with connective tissue disease,including 28 with Raynaud’s phenomenon and 24 without Raynaud’s phenomenon,and 30 normal controls were enrolled.A color microcirculation detector was used to evaluate the morphological features of nailfold capillaries and nailfold microcirculation indices.The nailfold microcirculation indices were also compared in patients with Raynaud’s pheomenon before and after treatment with alprostadil injection.Results In comparison with normal controls,patients with or without Raynaud’s pheomenon exhibited significantly higher morphological scores,flow scores,perimeter scores of capillary loops and total scores of nailfold microcirculation (P ＜ 0.01).Moreover,all these scores were higher in patients with Raynaud’s pheomenon than without Raynaud’s pheomenon (P ＜ 0.01).Treatments significantly decreased the morphological scores,flow scores,perimeter scores of capillary loops and total scores of nailfold microcirculation in patients with Raynaud’s pheomenon (P ＜ 0.01),but the morphological scores and total scores were still higher than that in normal controls (P ＜ 0.01).Conclusion The nailfold microcirculation can serve as an indicator for the diagnosis and evaluation of Raynaud’s pheomenon associated with connective tissue disease.Injections of alprostadil can improve the abnormalities of nailfold microcirculation.