类风湿关节炎膝关节病变及关节积液患者超声表现与ESR、CRP、IL-6、TNF-α关系研究

Relationship of ultrasound findings with ESR,CRP,IL-6,and TNF-αin patients with rheumatoid arthritis knee joint disease and joint effusion

目的探究类风湿关节炎膝关节病变及关节积液患者超声表现与红细胞沉降率(ESR)、C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的关系。方法选取2016年5月至2019年5月本院诊治的RA膝关节病变及关节积液患者68例作为研究组,同期健康体检者68例作为对照组。受试者均进行高频超声检查、实验室检查。比较两组超声指标(髌上囊液体厚度、滑膜厚度、关节腔液体深度、滑膜动脉血流指数)、实验室指标(血清IL-6、CRP、TNF-α、ESR)水平;分析超声指标与实验室指标的相关性。结果研究组髌上囊液体厚度、滑膜厚度、关节腔液体深度分别为(6.34±0.97)mm、(4.85±0.69)mm、(4.72±0.63)mm,均高于对照组(2.65±0.41)mm、(1.26±0.28)mm、(1.21±0.24)mm,滑膜动脉血流指数为(0.65±0.12),低于对照组(0.90±0.18),差异均有统计学意义(均P<0.05);研究组血清IL-6、CRP、TNF-α、ESR水平分别为(27.54±4.93)ng/L、(12.85±2.14)mg/L、(219.85±26.71)ng/L、(42.61±7.58)mm/h,均高于对照组(7.62±1.15)ng/L、(3.67±0.59)mg/L、(79.43±10.36)ng/L、(6.29±0.93)mm/h,差异均有统计学意义(均P<0.05);Pearson相关分析显示,髌上囊液体厚度、滑膜厚度、关节腔液体深度与IL-6、CRP、TNF-α、ESR均呈显著正相关(P<0.05),滑膜动脉血流指数与IL-6、CRP、TNF-α、ESR呈负相关(P<0.05)。结论RA膝关节病变患者的超声表现与IL-6、CRP、TNF-α、ESR存在明显相关性,可为临床患者的诊断与评估提供参考依据。

Objective To investigate the relationship of ultrasound findings with erythrocyte sedimentation rate(ESR),C reactive protein(CRP),interleukin 6(IL-6),and tumor necrosis factor-α(TNF-α)in patients with rheumatoid arthritis knee joint lesions and joint effusion.Methods 68 patients with RA knee joint lesions and joint effusion diagnosed and treated in our hospital from May,2016 to May,2019 were selected as a study group,and 68 healthy subjects a control group.All the subjects underwent high-frequency ultrasound examination and laboratory examination.The ultrasound indincators(liquid thickness of the upper sac,synovial thickness,fluid depth of the joint cavity,and synovial blood flow index)and laboratory indicators(serum IL-6,CRP,TNF-α,and ESR)were compared between the two groups.The correlation between ultrasound and laboratory indicators was analyzed.Results The fluid thickness,synovial thickness,and fluid depth of the joint cavity were higher and the synovial artery blood flow index was lower in the study group than in the control group[(6.34±0.97)mm vs.(2.65±0.41)mm,(4.85±0.69)mm vs.(1.26±0.28)mm,(4.72±0.63)mm vs.(1.21±0.24)mm,and(0.65±0.12)vs.(0.90±0.18);all P<0.05].The serum levels of IL-6,CRP,TNF-αand ESR were higher in the study group than in the control group[(27.54±4.93)ng/L vs.(7.62±1.15)ng/L,(12.85±2.14)mg/L vs.(3.67±0.59)mg/L,(219.85±26.71)ng/L vs.(79.43±10.36)ng/L,and(42.61±7.58)mm/h vs.(6.29±0.93)mm/h;all P<0.05].Pearson correlation analysis showed that the thickness of the supracondylar sac,the thickness of the synovial membrane,and the fluid depth of the joint cavity were significantly positively correlated with IL-6,CRP,TNF-α,ESR(all P<0.05);and synovial artery blood flow index was negatively correlated with IL-6,CRP,TNF-α,and ESR(all P<0.05).Conclusion The ultrasound findings of patients with RA knee joint disease are significantly correlated with IL-6,CRP,TNF-α,and ESR,which can provide references for the patients’clinical diagnosis and evaluation.