T2mapping序列对依那西普治疗强直性脊柱炎效果的评估价值

Value of T2mapping sequence in the evaluation on the efficacy of etanercept on ankylosing spondylitis

目的 利用磁共振成像（MRI）测量双侧骶髂关节面下骨髓T2值,探讨T2mapping序列在依那西普治疗强直性脊柱炎（AS）的疗效评估中的价值.方法 选择确诊并接受依那西普治疗的50例AS患者为A组,患者治疗前未应用任何生物制剂;B组为正常体检者（n=20）.测量B组T2mapping序列值以及A组治疗前后AS疾病活动指数（BASDAI）、红细胞沉降率（ESR）、C反应蛋白（CRP）和T2mapping值.结果 A组患者治疗前T2mapping序列值明显高于B组（P＜0.05）,且A组治疗前患者T2mapping序列值与BASDAI（5.37±1.73）、ESR[（38.56±25.14） mm/h]、CRP[（24.60±25.12）mg/L]存在相关性（r=0.738、P=0.000,r=0.765、P=0.000,r=0.615、P=0.000）.A组治疗后T2mapping序列值、BASDAI、ESR和CRP明显低于治疗前（P =0.021、0.015、0.000、0.000）.结论 AS患者T2mapping序列值显著高于正常人,且与BASDAI和ESR、CRP存在相关性.T2mapping序列可作为评价AS疾病活动性及AS预后的客观指标而应用于临床.

Objective To investigate the value of T2mapping in evaluating the efficacy of etanercept on ankylosing spondylitis （AS） through measuring bone marrow T2 in the bilateral sacroiliac joints by magnetic resonance imaging （MRI）.Methods Fifty patients who were diagnosed with AS and received etanercept treatment were selected as group A,and none of them used biological agent before treatment;normal people determined by physical examination were selected as group B （n =20）.T2mapping values of group B were measured;and the bath ankylosings pondylitis disease activity index （BASDAI）,erythrocyte sedimentation rate （ESR）,C-reactive protein （CRP） and T2mapping value of group A before and after treatment were measured.Results T2mapping sequence value of group A before treatment was significantly higher than that of group B （P 〈 0.05）,and it had correlation with BASDAI （5.37 ± 1.73）,ESR[（38.56 ±25.14）mm/h],CRP[（24.60 ±25.12） mg/L],r =0.738,0.765,0.615,all P =0.000.T2mapping sequence value,BASDAI,ESR,and CRP of group A after treatment were significantly lower than those before treatment （P =0.021,0.015,0.000,0.000）.Conclusions T2mapping sequence value in patient with AS is significantly higher than that in normal people,and is correlated with BASDAI,ESR and CRP.T2mapping can be used as an objective index to evaluate the activity and the prognosis of AS.