肌骨超声对147例类风湿性关节炎患者的评估价值分析

Analysis of the value of musculoskeletal ultrasound in the evaluation of 147 patients with rheumatoid arthritis

目的探讨肌骨超声(MSUS)对类风湿性关节炎(RA)患者的评估价值。方法选择我院2017年4月~2018年3月收治的147例类风湿性关节炎患者,根据病情分为发作组(n=74)和缓解组(n=73),并选择同期于我院检查的70例健康人为对照组(n=70)。所有研究对象均进行肌骨超声检查。比较三组的软骨厚度、积液厚度和滑膜厚度及发作组与缓解组的超声评分和DAS28评分。结果发作组和缓解组积液厚度和滑膜厚度明显高于对照组,且软骨厚度明显低于对照组,差异有统计学意义(P<0.05)。发作组积液厚度和滑膜厚度明显高于缓解组,且软骨厚度明显低于缓解组,差异有统计学意义(P<0.05)。发作组超声评分和DAS28评分与缓解组比较显著升高,差异均有统计学意义(t=7.914,P=0.000;t=13.990,P=0.000)。相关性分析结果提示超声评分和DAS28评分呈正相关,差异有统计学意义(r=0.781,P=0.031)。结论 MSUS评估诊断RA临床准确率高,早期诊断敏感度高,可为后续治疗提供有效依据,临床价值明显。

Objective To explore the value of musculoskeletal ultrasound in the evaluation of patients with rheumatoid arthritis.Methods 147 patients with rheumatoid arthritis admitted to our hospital from April 2017 to March 2018 were selected,and they were divided into attack group(n=74) and remission group(n=73) according to the condition.70 healthy people examined in our hospital in the same period were chosen as the control group(n=70).All subjects underwent musculoskeletal ultrasonography.The cartilage thickness,effusion thickness and synovial thickness of the three groups,the ultrasound score and the DAS28 score of the attack group and the remission group were observed and compared.Results The effusion thickness and synovial thickness in the attack group and the remission group was significantly higher than that in the control group,and the cartilage thickness in the attack group and the remission group was significantly lower than that in the control group(P<0.05).The effusion thickness and synovial thickness was significantly higher in the attack group than that in the remission group,and the cartilage thickness in the attack group was significantly lower than that in the remission group(P<0.05).The ultrasound score and DAS28 score in the attack group was significantly higher than that in the remission group,and the difference was statistically significant(t=7.914,P=0.000;t=13.990,P=0.000).Moreover,the correlation analysis showed that the ultrasound score was positively correlated with the DAS28 score,with statistically significant difference(r=0.781,P=0.031).Conclusion MSUS in the evaluation and diagnosis of RA has high clinical accuracy and high sensitivity in early diagnosis,which can provide effective evidence for follow-up treatment and has obvious clinical value.