摘要
目的比较伴慢性肾病痛风性关节炎（GcKD）与单纯性痛风性关节炎（GA）关节超声表现的差异，评估痛风石数目与肾功能受损程度的相关性。方法选取22例GCKD患者作为GCKD组，22例单纯GA患者作为单纯GA组，患者均进行常规及彩色多普勒超声检查，观察双侧膝、踝及第一跖趾关节（MTP1）痛风石数目、肌腱内聚集征、双边征、滑膜内点状强回声、滑膜增生、关节积液及骨侵蚀等征象的差异，计算肾功能受损程度与超声表现的相关性。结果GCKD组痛风石检出总数多于单纯GA组（Z=-3．915，P〈0．001），痛风石累及关节数多于单纯GA组（χ^2=20．283，P〈0．001），且GCKD组常表现为多关节受累，单纯GA组则常以无痛风石或单关节受累常见（χ^2=13．165，P=0．001）。GCKD组痛风石累及肌腱明显多于单纯GA组（χ^2=6．783，P=0．009），两组间肌腱聚集征差异无统计学意义（Z=-1．499，P=0．134）。GCKD组双边征多于单纯GA组（χ^2=7．511，P=0．006），两组间滑膜内点状强回声、滑膜增生、关节积液及骨侵蚀发生率差异均无统计学意义（χ^2=0．081，0．020，0．680，0．980；P=0．776，0．889，0．436，0．322）。估测肾小球滤过率（eGFR）、血清肌酐（SCr）及血尿素氮（BUN）与痛风石数目存在相关性（rs=-0．595，0．511，0．583；均P〈0．001）。结论GCKD患者更容易形成多发性痛风石，具有多关节受累趋势，更容易累及肌腱，双边征发生率较高。痛风石的数目与肾功能损害程度具有相关性。
Objective To compare the ultrasound differences between gouty arthritis with chronic kidney disease（GCKD） and simple gouty arthritis（GA）, and evaluate the correlation between the number of tophi and the degree of renal impairment. Methods Twenty-two patients with GCKD and 22 patients only with GA were examined by high frequency and color Doppler ultrasound. The differences hetween the tophus, intra-tendinous aggregate, double contour sign, hyperechoic spots in synovium, synovium hyperplasia, effusion and erosion of the knee, ankle and first metatarsophalangeal joint （MTP1） were examined. The correlation between the degree of renal impairment and the number of tophi was analyzed. Results The prevalence of tophi in GCKD group were significant serious compared with simple GA group （Z = - 3. 915, P〈0. 001 ）. The articulations involved tophi in GCKD group were more than those in simple GA group（χ^2 = 20. 283, P 〈0. 001）. And the tophi in GCKD group were more likely to involve multiple articulations while simple GA group frequently manifested none or single articulation involved（χ^2 = 13. 165, P = 0. 001）. The tophus in GCKD group was more frequently involved tendon than that in simple GA group （χ^2= 6.783, P = 0.009）, but the number of aggregates in tendon showed no significant difference between the two groups （ Z = - 1. 499, P = 0. 134）. The double contour sign was more frequent in GCKD group than that in simple GA group（χ^2 = 7.511, P = 0.006）, there was no difference of hypereehoic spots in synovium, synovium hyperplasia, effusion and erosion between the two groups. The number of tophi was correlated with estimated glomerular filtration rate （eGFR）, serum creatinine（SCr） and blood urea nitrogen （BUN） （rs= -0.595,0.511,0.583;allP 〈0.001）,respectively. Conclusions GCKD is more likely to manifest multiple tophi, multiple tophus-involved articulations, intra-tendinous tophi and double contour sign. The number of tophi is correlated with the degree of renal
作者
陆蓓蕾
黄备建
李翠仙
王培蕾
Lu Beilei;Huang Beijian;Li Cuixian;Wang Peilei(Department of Ultrasound,Zhongshan Hospital of Fudan University ＆ Shanghai Institute of Medical Imaging,Shanghai 200032,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2018年第9期805-810,共6页
Chinese Journal of Ultrasonography
基金
上海市自然科学基金（16ZR1433200）
关键词
超声检查
痛风
关节炎
慢性肾病
Ultrasonography
Gout
Arthritis
Chronic kidney disease
