高频超声在类风湿关节炎双手关节病变的应用价值

Clinical significance of high frequency ultrasonography of finger joints in patients with rheumatoid arthritis

目的:探讨高频超声在类风湿关节炎(RA)患者双手关节病变的应用价值。方法:高频超声、X线检查108例活动期RA的腕关节和12例临床缓解期RA的腕、掌指、近端指间关节,分析其影像学特征。结果:108例活动期RA按病程分为两组,检查216个腕关节。病程<1年组的患者骨侵蚀及腱鞘病变显著低于病程≥1年组(P<0.01)。病程<1年组超声发现骨侵蚀率明显高于X线(P<0.05)。而病程≥1年组超声发现骨侵蚀率低于X线,差异无统计学意义(P>0.05)。12例临床缓解期RA共检查264个关节,超声发现滑膜炎的阳性率明显高于体格检查(P<0.05)。结论:RA疾病早期高频超声发现骨侵蚀优于X线;临床缓解期超声发现滑膜炎的敏感性高于体格检查。

Objective To investigate the significance of uhrasonography in the examination of rheumatoid arthritis（RA）. Methods The wrist joints of activated RA and wrist, metacarpophalangeal, proximal interphalangeal joints of remission of RA were determined, and the imaging features were analyzed. Results Patients with activated RA were divided into two groups. The bone erosion and sheath lesions were lower in the group of duration less than 1 year than those in the group of duration over 1 year （P 〈 0.01）. The positive rate of ultrasound was higher than that of X-ray in bone erosion （P 〈 0.05）. To patients with the remission of RA, the positive rate of ultrasound was higher than that of the physical examination in synovitis （P 〈 0.05）. Conclusions For bone erosion, ultrasound is better than X-ray for patients with early RA. For synovitis, the sensitivity of uhrasonography is higher than the physical examination in remission for RA patients.