超声影像学对非布司他治疗痛风性关节炎的效果验证探讨

Effect of Ultrasound Imaging on the Efficacy of Febuxostat in the Treatment of Gouty Arthritis

目的验证超声影像学对非布司他治疗痛风性关节炎的效果。方法随机选取2018年4月—2019年4月该院免疫风湿病科痛风性关节炎患者80例,给予所有患者非布司他治疗,对所有患者进行超声检查,然后统计分析80例患者432个受试关节治疗前后的超声影像学表现、肌腱周围强回声、暴雪样回声超声表现、血尿酸水平。结果 80例患者432个受试关节治疗后的0级双轨征、滑膜增厚、关节积液、血流显像比例92.6%(400/432)、99.1%(428/432)、96.3%(416/432)、99.1%(428/432)均显著高于治疗前77.8%(336/432)、94.4%(408/432)、83.3%(360/432)、93.5%(404/432)(χ^2=6.63、9.21、11.34、13.28,P<0.05);1级双轨征比例55.6%(24/432)显著高于治疗前9.3%(40/432)(χ^2=13.34,P<0.05),滑膜增厚、关机积液、血流显像比例0.9%(4/432)、2.8%(12/432)、0.9%(4/432)均显著低于治疗前4.6%(20/432)、9.7%(42/432)、4.6%(20/432)(χ^2=5.02、7.38、9.35,P<0.05);2级双轨征、滑膜增厚、关节积液、血流显像比例1.9%(8/432)、0.0%、0.9%(4/432)、0.0%均显著低于治疗前8.3%(36/432)、0.9%(4/432)、3.7%(16/432)、1.9%(8/432)(P<0.05);3级双轨征比例0.0%显著低于治疗前4.6%(20/432)(χ^2=16.01,P<0.05)。432个受试关节治疗后的肌腱周围强回声、暴雪样回声比例0.0%、0.0%均显著低于治疗前10.2%(44/432)、9.3%(40/432)(χ^2=12.83、11.14,P<0.05)。治疗后的血尿酸水平(335.6±59.4)μmol/L显著低于治疗前(544.2±82.3)μmol/L,差异有统计学意义(t=6.965,P<0.05)。结论超声影像学能够有效验证非布司他治疗痛风性关节炎的效果。

Objective To verify the effect of ultrasound imaging on the treatment of gouty arthritis with febuxostat. Methods Eighty patients with gouty arthritis in our department of immunology and rheumatology from April 2018 to April 2019 were randomly selected. All patients were treated with febuxostat. Ultrasonography was performed on all patients, and then 80 patients were statistically analyzed. Ultrasound imaging findings before and after treatment of the joints, strong echoes around the tendons, blizzard-like echoes, and blood uric acid levels. Results The ratio of grade 0 double-track, synovial thickening, joint effusion, and blood flow imaging after 432 joint treatments in 80 patients were 92.6%(400/432), 99.1%(428/432), and 96.3%(416/432) and 99.1%(428/432) were significantly higher than 77.8%(336/432), 94.4%(408/432), 83.3%(360/432), and 93.5%(404/432) before treatment.(χ^2=6.63, 9.21, 11.34, 13.28, P<0.05);the ratio of grade 1 double-track was 55.6%(24/432) was significantly higher than 9.3%(40/432) before treatment (χ^2=13.34, P<0.05). Synovial thickening, shutdown effusion, and blood flow imaging ratios of 0.9%(4/432), 2.8%(12/432), and 0.9%(4/432) were significantly lower than that before treatment 4.6%(20/432), 9.7%(42/432), 4.6%(20/432)(χ^2=5.02, 7.38, 9.35, P<0.05);Grade 2 double-track sign, synovial thickening, joint effusion, blood flow imaging ratio 1.9%(8/432), 0.0%, 0.9%(4/432), 0.0% were significantly lower than 8.3%(36/432), 0.9%(4/432), 3.7%(16/432), 1.9%(8/432) before treatment (P<0.05);the proportion of grade 3 double-track was significantly lower than 4.6%(20/432) before treatment (χ^2=16.01, P<0.05). The ratio of strong echo and blizzard-like echoes around the 432 joints after treatment 0.0%,0.0% was significantly lower than 10.2%(44/432) and 9.3%(40/432) before treatment (χ^2=12.83, 11.14, P<0.05). The blood uric acid level after treatment (335.6±59.4)μmol/L was significantly lower than that before treatment (544.2±82.3)μmol/L,the difference was statistically significant (t=6.965, P<0.05). Conclusion Ultrasound imaging can effectively verify the efficacy of febuxostat in the treatment of gouty arthritis.