肌骨超声半定量分级与类风湿性关节炎患者关节活动度的相关性研究

Correlation between semi-quantitative muscular ultrasound and joint activity in rheumatoid arthritis patients

目的探究肌骨超声半定量分级与类风湿性关节炎(RA)患者关节活动度之间的关联性。方法回顾性选取2016年1月至2017年12月于陕西中医药大学第二附属医院进行就诊并确诊的RA患者58例为研究对象,使用28处关节疾病活动度(DAS28)评分对患者病情进行评估,并按照得分将患者区分为缓解期组(12例)、低活动期组(16例)、中活动期组(18例)及高活动期组(12例),而后使用彩色多普勒超声对所有患者的7个手足关节进行检测,依据超声半定量评分系统对患者的滑膜增生、滑膜内血流信号、骨侵蚀及关节积液4项指标进行评估,而后对所有患者的红细胞沉降率(ESR)、C反应蛋白(CRP)及类风湿因子(RF)进行测量对比,最后对患者膝关节活动度进行测量评估。结果随着患者病情的加重,其滑膜增生、滑膜内血流信号、骨侵蚀、关节积液评分呈上升趋势,ESR、CRP、RF水平呈现上升趋势,膝关节活动度呈下降趋势,组间对比差异具有统计学意义(P <0. 05)。相关性分析发现,肌骨超声定量评分与ESR、CRP、RF水平呈正相关,与关节活动度呈负相关。结论肌骨超声半定量分级与RA患者关节活动度存在负相关,可以通过超声检测的方式对RA的病情进行预判。

Objective To explore the correlation between semi-quantitative musculoskeletal ultrasound grading and joint mobility in patients with rheumatoid arthritis(RA).Methods A retrospective study of 58 patients with RA who were diagnosed in our hospital from January 2016 to December 2017 was evaluated.The condition of the joint disease was evaluated using 28 joint disease activity(DAS28)scores.and the patients were divided into remission group(12 cases),low activity group(16 cases),Middle active group(18 cases)and high activity group(12 cases).All patients were examined by color Doppler ultrasonography for seven hands and feet joints.According to the semi-quantitative ultrasound system,the synovial hyperplasia,Synovial blood flow signals,bone erosion and joint effusion 4 indicators were assessed,and then all patients with Erythrocyte sedimentation rate(ESR)C-reactive protein(CRP)and Rheumatoid Factor(RF)were measured and compared.Finally,the knee joint mobility of patients was measured and evaluated.Results With the aggravation of the patient's condition,synovial hyperplasia,synovial flow signal,the scores of edema and joint effusion showed an upward trend.The levels of ESR、CRP and RF showed an upward trend while the activity of knee showed a downward trend.The difference between the two groups was statistically significant(P<0.05).The results showed that the muscular ultrasound quantitative score positively correlated with serum ESR、CRP、RF levels and negatively correlated with joint activity.Conclusion Semi-quantitative musculoskeletal classification and joint mobility in patients with RA exist Negative correlation,you can detect the way by ultrasound on the prognosis of RA.