MRI骶髂关节评分系统对益赛普治疗强直性脊柱炎疗效的评估价值

THE VALUE OF MRI SACROILIAC JOINT SCORING SYSTEM TO ASSESS THE EFFICACY OF ETANERCEPT FOR THE TREATMENT OF ANKYLOSING SPONDYLITIS

目的探讨MRI骶髂关节评分系统对于评价益赛普治疗强直性脊柱炎(AS)骶髂关节病变疗效的价值。方法收集47例经益赛普治疗的AS炎性活动期病例,分别于治疗前及治疗半年后行MRI平扫,然后分别对患者治疗前及治疗后两侧骶髂关节骨髓水肿的情况进行影像学上的评分,将影像评分与临床疗效作对比研究。结果 47例AS中,治疗前骶髂关节骨髓水肿MRI评分为18~110分,治疗后为3~93分,治疗前后评分差值为-13~49分。评分差值>28分25例,5分~28分17例,<5分5例。与临床评价疗效比较,MRI评分差值判断疗效为显效、有效及无效的准确率分别为80%(20/25)、76.47%(13/17)和100%(5/5)。二者经一致性比较,Kappa值=0.67>0.4。结论 MRI骶髂关节炎性评分系统与临床疗效评估有较好的一致性,能为AS患者活动期疗效评估提供一个较为客观的依据。

Objective To explore the MRI sacroiliac joint scoring system for evaluation of etanercept in the treatment of ankylosing spondylitis （AS） the curative effect of sacroiliac joint lesions. Methods Fortyseven patients with AS treated with a 6-month therapy were enrolled in this study. All the patients underwent MRI examination before and after treatment and analyzed the correlation of treatment effects between MRI score and the clinical score. Results The Result of MRI assessment was excellent,effective or ineffective in 25,17 and 5 patients. The accuracy was 80%,76.47% and 100% respectively. The comparison of consistency, Kappa value = 0.67 〉 0.4. Conclusion MRI sacroiliac joint inflammatory scoring system has good consistency with clinical curative effect evaluation, so MRI can be used as an objective method in the therapeutic evaluation of AS.