摘要
目的观察超声成像在类风湿关节炎(RA)早期诊断中的效果,并探讨其在活动性评估中的应用价值。方法选取确诊为RA的患者52例作为观察组,另选择体检的正常人52例作为对照组,2组均给予超声检查,比较2组膝关节与肘关节的积液、滑膜、软骨厚度以及滑膜彩色血流。对入选的52例RA患者进行治疗,分别于治疗前后对同一关节行超声检查,记录滑膜厚度、血流阻力指数(RI)和分布、骨皮质侵蚀程度,将超声指标与同期C-反应蛋白(CRP)、抗环瓜氨酸肽(CCP)抗体、红细胞沉降率(ESR)、简化疾病活动指数(SDAI)以及类风湿因子(RF)进行相关性分析。结果观察组治疗前显示血流较为丰富,多为树枝状或点状,而对照组则不显示血流。观察组膝关节和肘关节积液深(厚)度、滑膜厚度显著高于对照组(P<0.05),软骨厚度显著低于对照组(P<0.05)。观察组治疗后血流分布、滑膜厚度、CRP、抗CCP抗体、ESR、RF显著低于治疗前(P<0.05),RI显著高于治疗前(P<0.05);其中关节滑膜厚度、血流分布分别与CRP、抗CCP抗体、ESR、RF、SDAI呈正相关(P<0.05);RI与CRP、抗CCP抗体、ESR、RF、SDAI呈负相关(P<0.05),骨皮质侵蚀无明显变化。结论通过超声成像观察关节的积液、滑膜、软骨厚度和血流分布,能够准确诊断RA,并为其活动性评估提供依据。
Objective To observe the effect of ultrasound imaging in early diagnosis of rheumatoid arthritis（RA）,and to explore its application value in activity evaluation. Methods Fifty-two patients with RA who were diagnosed in our hospital were selected as observation group. And fifty-two healthy subjects who received physical examination in our hospital were selected as control group. Ultrasound examination was performed in both groups to compare the effusions,synovial tissue,thickness of articular cartilage and synovial color flow of the knees and elbow joints in the two groups. The same joint of patients in observation group was examined by ultrasound before and after treatment. The synovial thickness,blood flow resistance index（RI） and distribution,as well as cortical erosion,were recorded. Moreover sonographic index,CRP,anticyclic citrullinated peptide（CCP） antibodies,erythrocyte sedimentation rate（ESR）,simplified disease activity index（SDAI） and rheumatoid factor（RF） were used for correlation analysis. Results Before treatment,more blood flow of patients in observation group was observed in observation group,mostly in dendritic or punctate shape,howevr,which was not observed in control group. The depth（thickness） and synovial thickness of knee and elbow joints in observation group were significantly higher than those in control group（P〈 0. 05）,however,the cartilage thickness in observation group was significantly lower than that in control group（P〈 0. 05）. After treatment,blood flow distribution,synovial thickness,CRP,anti-CCP antibody,ESR and RF in observation group were significantly lower than those before treatment（P〈 0. 05）,but RI in observation group was significantly higher than that before treatment（P〈 0. 05）. The synovial thickness and distribution of blood flow were positively correlated with CRP,anti-CCP antibody,ESR,RF,and SDAI,respectively,but RI in observation group was negatively correlated with CRP,anti-CCP antibody,ESR,RF,SDAI. In addition,there w
作者
宋绍艳
SONG Shaoyan(The Third People＇s Hospital of Xining City,Qinghai,Xining 810005,China)
出处
《河北医药》
CAS
2018年第15期2353-2355,共3页
Hebei Medical Journal
关键词
超声成像
类风湿关节炎
早期诊断
活动性评估
ultrasound imaging
rheumatoid arthritis
early diagnosis
activity assessment
