Dermatomyositis (DM) is frequently complicated by interstitial lung disease (ILD), which increases mortality. This study aims to elucidate the clinical significance of nailfold videocapillaroscopy (NVC) on assessing the disease activity and prognosis of DM-ILD. We compared the NVC findings between anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody-positive and anti-aminoacyl tRNA synthetase (anti-ARS) antibody-positive patients, the survival and ILD-related death groups, and examined the association of NVC findings with prognostic factors of DM-ILD. The median scores of microhemorrhage and capillary disorganization in the anti-MDA5 antibody-positive group were significantly higher than those in the anti-ARS antibody-positive group (P = 0.012 and 0.044, respectively). In contrast, the median scores of tortuous capillaries in the anti-ARS antibody-positive group were significantly higher than those in the anti-MDA5 antibody-positive group (P = 0.002). The median scores of microhemorrhage was significantly higher in the ILD-related death group than the survival group (P = 0.02). The scores of microhemorrhage, capillary disorganization, and neoangiogenesis correlated with known poor prognosis factors of DM-ILD. Additionally, the scores of microhemorrhage and capillary loss correlated significantly with the total fibrosis scores of chest high-resolution computed tomography. These findings suggest that NVC is a useful tool for assessing the disease activity and prognosis of DM-ILD.

皮肌炎 (DM) 经常并发间质性肺病 (ILD)，这会增加死亡率。本研究旨在阐明甲襞视频毛细血管镜检查（NVC）在评估DM-ILD疾病活动度和预后方面的临床意义。我们比较了抗黑色素瘤分化相关基因 5（抗 MDA5）抗体阳性和抗氨酰 tRNA 合成酶（抗 ARS）抗体阳性患者、存活和 ILD 相关死亡组之间的 NVC 结果，并检查了NVC 发现与 DM-ILD 预后因素的关联。抗 MDA5 抗体阳性组微出血和毛细血管紊乱的中位评分显着高于抗 ARS 抗体阳性组（P. = 0.012 和 0.044，分别）。相比之下，抗 ARS 抗体阳性组曲折毛细血管的中位评分显着高于抗 MDA5 抗体阳性组（P  = 0.002）。ILD相关死亡组微出血的中位评分显着高于生存组（P  = 0.02）。微出血、毛细血管紊乱和新血管生成的评分与已知的 DM-ILD 预后不良因素相关。此外，微出血和毛细血管丢失的评分与胸部高分辨率计算机断层扫描的总纤维化评分显着相关。这些发现表明 NVC 是评估 DM-ILD 疾病活动性和预后的有用工具。