应用7关节超声评分评价类风湿关节炎达标治疗

Application of 7-joint ultrasound score in evaluation on treat-to-target of rheumatoid arthritis

目的探讨7关节超声评分在类风湿关节炎达标治疗中的应用价值。方法收集活动期40例类风湿关节炎患者,遵循临床达标治疗原则,分析治疗前后28关节疾病活动度(DAS28)、滑膜炎、肌腱腱鞘炎及7关节超声评分的变化,并对滑膜炎、腱鞘炎及7关节超声评分变化量与DAS28变化量行相关性分析。结果与治疗前相比,类风湿关节炎患者治疗后DAS28、滑膜炎、肌腱腱鞘炎及7关节超声评分均减低,差异均有统计学意义(P均<0.001);治疗前后骨侵蚀差异无统计学意义(P=0.317)。治疗前后滑膜炎、肌腱腱鞘炎及7关节超声评分变化量与DAS28变化量均呈弱正相关(r_s=0.363、0.318、0.317,P=0.021、0.045、0.047)。结论 7关节超声评分可为评价类风湿关节炎达标治疗效果提供参考,但不推荐仅以超声缓解作为达标治疗的检测指标。

Objective To explore the application value of 7-joint ultrasound score in the treat-to-target of rheumatoid arthritis. Methods Totally 40 patients with rheumatoid arthritis in active stage were enrolled. The changes of disease activity score of 28 joints(DAS28), synovitis, tenosynovitis and 7-joint ultrasound score before and after treatment were analyzed in accordance with the principles of clinical standard treatment, and the correlation of changes of synovitis, tenosynovitis, 7-joint ultrasound score and changes of DAS28 were analyzed. Results Compared with those before treatment, DAS28, synovitis, tenosynovitis and 7-joint ultrasound score decreased significantly after escalation therapy(all P<0.001), but changes in bone erosion were not statistically significant(P=0.317). The changes of synovitis, tenosynovitis, 7-joint ultrasound score and DAS28 showed relatively weak correlation(r_s=0.363, 0.318, 0.317, P=0.021, 0.045, 0.047). Conclusion 7-joint ultrasound score can be used to detect changes of disease activity of rheumatoid arthritis, but not yet be advocated as testing index for treat-to-target escalation.