磁共振成像在评价强直性脊柱炎疾病活动中的价值研究

The value research of magnetic resonance imaging in evaluating the disease activity of ankylosing spondylitis

目的观察益赛普治疗强直性脊柱炎(ankylosing spondylitis,AS)疾病活动度的改善,评价磁共振成像(aagnetic resonance imaging,MRI)在AS疾病活动中的作用。方法将符合纳入标准的80例AS患者随机分为两组,每组40例,治疗组使用益赛普联合甲氨蝶呤,对照组使用甲氨蝶呤联合柳氮磺胺吡啶,分别在治疗0、4、8、12、16、20、24w采用毕氏AS疾病活动指数(bath ankylosing spondylitis disease activity index,BASDAI)、AS疾病活动性评价指数1(ankylosing spondyltis disease activity score 1,ASDAS1)、骶髂关节MRI炎症评分及炎症减轻程度对两组进行疾病活动度改善的评价。结果 (1)治疗4、8、12w时,治疗组BASDAI和ASDAS1较对照组明显改善(P<0.05),治疗组治疗4w后,BASDAI和ASDAS1较治疗前明显改善(P<0.05);(2)治疗8、12w时,治疗组MRI炎症评分较对照组明显改善(P<0.05),治疗组治疗8w后,MRI炎症评分较治疗前明显改善(P<0.05),治疗8、12、16w时,治疗组MRI炎症减轻程度较对照组明显改善(P<0.05),且较治疗4w时明显改善(P<0.05)。结论益赛普治疗强直性脊柱炎8w时可达到症状及影像学双重缓解,治疗8w可作为益赛普减量的界限,磁共振(MRI)可作为益赛普减量的重要依据。

Objective To observe the improvement on the disease activity of ankylosing spondylitis （AS） with the treatment of etanercept and evaluate the role of the magnetic resonance imaging in disease activity of AS .Methods We divided the 80 patients who fit the inclusion criteria into two groups randomly ,with 40 patients in each group .The treatment group used the treatment of etanercept and methotrexate .The control group used the treatment of methotrexate and salazosulfapyri -dine .We used the Bath ankylosing spondylitis disease activity index （BASDAI） ,ankylosing spondyltis disease activity score 1 （ASDAS1） ,in-flammation scores of the sacroiliac joint MRI and the degree of inflammation alleviation of the sacroiliac joint MRI to evaluate the disease activity in two groups in the treatment of 0 ,4 ,8 ,12 ,16 ,20 ,24 weeks respectively .Results （1）When we compared the treatment group with the control group ,BASDAI and ASDAS1 had significant improvement after 4 ,8 ,12 weeks （P〈0 .05） ,after 4 weeks treatment ,BASDAI and ASDAS1 had significant improvement compared to the 0 week in the treatment group ;（2） When we＆nbsp;compared the treatment group to the control group ,the inflammation scores of the sacroiliac joint MRI had siginificant improvement after 4 ,12 weeks （P 〈0 .05） ,after 8 weeks treatment ,the inflammation scores had significant improvement compared to the 0 week in the treatment group ;When we compared the treat-ment group to the control group ,the degree of inflammation alleviation of the sacroiliac joint MRI had marked improvement after 8 ,12 ,16 weeks′ treatment （P 〈 0 .05） ,compared to the the moment of 4 weeks treatment （P 〈 0 .05） .Conclusion The AS patients who were treated by the etanercept after 8 weeks′treatment can achieve dual alleviation in symptom and imaging .The treatment of 8 week can be re-garded as a beginning point of the reduction of etanercept treatment ,and the M RI can be regarded as an important basis for the decrement of etanercept treatment .