超声评分法在类风湿关节炎的应用研究

发布时间：2019-04-24 04:25

【摘要】：目的探讨超声评分法在评价类风湿关节炎患者疾病活动性的诊断价值。方法通过高频超声观察39例类风湿关节炎患者掌指关节、近端指间关节、腕关节、肘关节和膝关节的病变,包括滑膜厚度、滑膜血流、关节积液和骨侵蚀,根据病情的严重程度对上述各项指标予以评分(0~3分),将双侧各个关节的评分相加为最终得分,探讨超声评分与DAS28评分及4种生化检查(血沉ESR、C-反应蛋白CRP、类风湿因子RF、抗环瓜氨酸肽抗体AntiCCP)之间的相关性。结果超声评分与DAS28评分之间存在非常显著的相关性(r=0.823,P0.01),超声评分与CRP的相关性优于DAS28评分与CRP的相关性(r超声评分=0.692,rDAS28=0.526,P值0.01)。超声评分各个子项目中滑膜厚度与DAS28评分及生化检查(ESR、CRP)相关性最好(rDAS28=0.852,rESR=0.779,rCRP=0.587,P值均0.01)。结论超声评分法对类风湿关节炎疾病活动性的诊断与DAS28评分和血清学指标(ESR、CRP)基本吻合,且超声评分可能优于DAS28评分,可作为该病早期诊断、病情判断和预后观察的一种有效方法。超声评分各个子项目中滑膜厚度最能够反映类风湿关节炎疾病的活动性。
[Abstract]:Objective to evaluate the diagnostic value of ultrasound score in the diagnosis of rheumatoid arthritis (RA). Methods the changes of metacarpophalangeal joint, proximal interphalangeal joint, wrist joint, elbow joint and knee joint in 39 patients with rheumatoid arthritis were observed by high frequency ultrasound, including synovial thickness, synovial blood flow, joint effusion and bone erosion. According to the severity of the disease, the above indexes were graded (0 ~ 3 points), and the scores of bilateral joints were added to the final score. The ultrasonic score and DAS28 score as well as four biochemical tests (erythrocyte sedimentation rate ESR,C- reactive protein CRP,) were discussed. Correlation between rheumatoid factor RF, anti-cyclic citrullinated peptide antibody AntiCCP. Results there was a significant correlation between ultrasound score and DAS28 score (r = 0.823, P0.01). The correlation between ultrasound score and CRP score was better than that between DAS28 score and CRP score (r ultrasound score = 0.692, rDAS28 / 0.526, P < 0.01). The thickness of synovial membrane had the best correlation with DAS28 score and biochemical examination (ESR,CRP) in each sub-item of ultrasound score (rDAS28=0.852,rESR=0.779,rCRP=0.587,P = 0. 01). Conclusion the diagnostic value of ultrasound score for rheumatoid arthritis disease activity is basically consistent with the DAS28 score and serological index (ESR,CRP), and the ultrasonic score may be better than the DAS28 score, so it can be used as the early diagnosis of rheumatoid arthritis. It is an effective method to judge the state of illness and to observe the prognosis. The thickness of synovium in each sub-item could best reflect the activity of rheumatoid arthritis.
【作者单位】：福建医科大学附属漳州市医院超声科;泉州医学高等专科学校;
【分类号】：R593.22;R445.1

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