超声检查在类风湿关节炎膝关节积液诊断中的应用

Evaluation of knee joint-effusion in patients with rheumatoid arthritis by ultrasonography

目的 探讨超声显像检查在膝关节积液诊断中的应用以及膝关节积液与类风湿关节炎病情的关系。方法 采用超声显像检查 ,对 10 0例正常人膝关节及 10 0例类风湿关节炎患者膝关节进行检查。结果 ①正常人双膝关节腔内积液无回声区均小于 0 17± 0 0 5cm ;以 >0 3cm为界 ,关节积液阴性与阳性两组之间差异有显著意义 (P <0 0 1) ;② 10 0例类风湿关节炎患者膝关节积液多为对称性 ,其左侧和右侧积液发生率分别为 5 2 9%和 6 1 4 % ;③类风湿关节炎患者膝关节积液程度与炎性指标ESR相关 (P <0 0 1) ,与RF滴度无相关。结论 ①正常人双膝关节腔内积液小于 0 2cm ,超过 0 3cm即可认为有膝关节积液存在 ;②类风湿关节炎患者膝关节积液发生率较高 ,其积液量的变化与ESR相关 ,可作为病情变化的观察指标之一。因此 ,超声显像检查膝关节积液是一种简单、无创、快捷和优于膝浮膑征检查的方法。

Objective To investigate the application of ultrasonography in detecting knee-joint effusion and the relationship between knee-joint effusion and disease activity of rheumatoid arthritis(RA).Methods Ultrasonography of knees in 100 patients with rheumatoid arthritis were performed and the results was compared with that of 100 healthy individuals.Results (1)The depth of echo-free area in knee joint in patients with RA was less than that in the healthy;(2)The prevalence of knee effusion in left and right knee in patients with RA were 52.9% and 61.4% respectively;(3)The quantity of knee-effusion was correlated to ESR(P<0.01),but not to RF.Conclusion (1)The range of knee effusion is less than 0.2cm by ultrasonography in normal individuals and it is considered abnormal when over 0.3cm;(2)The quantity of knee effusion is one of the useful markers for monitoring diseases activity of RA;(3)Ultrasonography is a useful and non-invasive method for detecting joint effusion.