摘要
目的:探讨肌骨超声在类风湿性指关节炎病情活动性及炎性病变中的评估价值。方法:选取郑州大学附属郑州市中心医院2021年9月至2023年5月收治的70例类风湿性指关节炎患者作为研究对象,依照类风湿性关节炎疾病活动性评分系统(DAS28)评分结果进行不同病情活动性分组。对所有患者指关节进行肌骨超声诊断,分析不同病情活动性患者指关节肌骨超声的图像特征并进行超声半定量评分,建立受试者工作特征(ROC)曲线,分析肌骨超声相关半定量评分对于患者病情活动性的评估效能。比较肌骨超声诊断不同病变患者类风湿因子(RF)、红细胞沉降率(ESR)、超敏C反应蛋白(hs–CRP)相关因子水平。并采用Spearman相关性分析肌骨超声诊断的不同病变与炎性病变的相关性。结果:70例患者中活动期患者47例,缓解期患者23例。确诊为骨侵蚀病变的患者43例,确诊为关节积液病变的患者62例,确诊为滑膜增生病变的患者51例。缓解期组患者关节积液、骨侵蚀、滑膜内血流信号、滑膜增厚评分以及肌骨超声半定量评分均明显低于活动期组,差异具有统计学意义(P <0.05)。肌骨超声半定量评分对于类风湿性指关节炎病情活动性的评估灵敏度、特异度分别为83.23%、94.14%。不同骨侵蚀、关节积液病变患者RF、ESR、hs–CRP水平比较,差异具有统计学意义(P <0.05);不同滑膜增生病变患者RF、ESR、hs–CRP水平比较,差异无统计学意义(P> 0.05)。Spearman相关分析结果显示骨侵蚀病变、关节积液病变与RF、ESR、hs–CRP呈正相关(P <0.05),滑膜增生病变与RF、ESR、hs–CRP无明显相关性(P> 0.05)。结论:肌骨超声对于类风湿性指关节炎病情活动性的评价具有较高应用价值,可通过关节积液、骨侵蚀情况来综合反应患者的炎性病变情况,对类风湿性指关节炎的病情评估、预后评价具有重要价值。
Objective To explore the evaluation value of musculoskeletal ultrasound in the active and inflammatory lesions of rheumatoid finger arthritis.Methods A total of 70 patients with rheumatoid finger arthritis admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from September 2021 to May 2023 were selected as the research subjects.Different disease activity groups were divided according to the results of the rheumatoid athritis disease activity scoring system(DAS28).Musculoskeletal ultrasound diagnosis was performed on the finger of all patients.Image features of musculoskeletal ultrasound in patients with different disease activity were analyzed and semi-quantitative ultrasound scores were performed.Receiver operating characteristic(ROC)curve was established to analyze the efficacy of musculoskeletal ultrasound correlation semi-quantitative score in evaluating patients'disease activity.The levels of rheumatoid factor(RF),erythrocyte deactivation rate(ESR)and hypersensitive C-reactive protein(hs-CRP)related factors were compared in patients with different lesions diagnosed by musculoskeletal ultrasound.Spearman correlation was used to analyze the correlation between different lesions diagnosed by musculoskeletal ultrasound and inflammatory lesions.Results Of the 70 patients,47 cases were active and 23 cases were in remission.There were 43 patients diagnosed with bone erosion,62 patients diagnosed with joint effusion and 51 patients diagnosed with synovial hyperplasia.The scores of Joint effusion,bone erosion,intrasynovial blood flow signal,synovial thickening score and musculoskeletal ultrasound semi-quantitative in the remission group were significantly lower than those in the active group,with statistical significance(P<0.05).The sensitivity and specificity of musculoskeletal ultrasound semi-quantitative score for evaluating the disease activity of rheumatoid digital arthritis were 83.23%and 94.14%,respectively.There was a significant difference in the levels of RF,ESR,and hs-CRP among patient
作者
韩雪莉
崔智飞
杨玉娇
HAN Xueli;CUI Zhifei;YANG Yujiao(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Henan Zhengzhou 450000)
出处
《深圳中西医结合杂志》
2023年第22期22-26,F0003,共6页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
类风湿性关节炎
指关节
肌骨超声
Rheumatoid arthritis
Finger
Musculoskeletal ultrasound
