肌骨超声在类风湿关节炎评估中的应用价值分析

Analysis of the Application Value of Musculoskeletal Ultrasound in the Evaluation of Rheumatoid Arthritis

目的探究肌骨超声在类风湿关节炎评估中的应用价值。方法 2016年12月-2018年12月从该院便利选取106例类风湿关节炎患者,根据患者是否处于疾病的活动期,将患者分为两组,缓解期组和活动期组,每组53例患者,缓解期组DAS28评分低于3.2分,活动期组的DAS28评分不低于3.2分。观察比较两组患者的超声评分和相关血液学指标,分析活动期患者超声评分与相关血液学指标、DAS28评分的相关性,以及超声评分对类风湿关节炎缓解和活动鉴别的诊断价值。结果缓解期组患者的超声评分为(11.5±4.6)分,肿瘤坏死因子-α(TNF-α)为(12.9±2.3) ng/L,C-反应蛋白(CRP)为(6.6±1.5)mg/L,活动期组患者的超声评分为(22.3±3.7)分,肿瘤坏死因子-α(TNF-α)为(19.3±4.7)ng/L,C-反应蛋白(CRP)为(18.2±2.7) mg/L,两组数据差异有统计学意义(t=10.526、12.716、15.853,P=0.001、0.001、0.001<0.05)。活动期组患者的超声评分,与TNF-α、CRP、DAS28评分,有明显的正相关关系。经过ROC曲线分析,超声评分诊断患者属于活动期的特异性83.65%,敏感性88.93%。结论肌骨超声在类风湿关节炎评估中具有重要的应用价值,能够有效评估患者处于活动期或者缓解期,具有临床应用价值。

Objective To explore the value of musculoskeletal ultrasound in the evaluation of rheumatoid arthritis. Methods106 patients with rheumatoid arthritis were convenienty selected from December 2016 to December 2018 in the hospital.According to whether the patients were in the active stage of the disease, the patients were divided into two groups, the remission group and the active stage group, 53 patients in each group, the DAS28 score of the remission group was lower than3.2 points, and the DAS28 score of the active stage group was not lower than 3.2 points. Observe and compare the two groups of patients with ultrasound score and related hematological indicators, analyze the correlation between ultrasound score and related hematological indicators, DAS28 score, and the value of ultrasound score in the diagnosis of rheumatoid arthritis remission and activity differentiation. Results Patients in the remission phase had an ultrasound score of(11.5±4.6)points, tumor necrosis factor-α(TNF-α) was(12.9±2.3) ng/L, and C-reactive protein(CRP) was(6.6±1.5) mg/L. Ultrasound score was(22.3±3.7)points, tumor necrosis factor-α(TNF-α) was(19.3±4.7) ng/L, and C-reactive protein(CRP) was(18.2±2.7) mg/L. There was statistically significant difference between the two groups(t=10.526, 12.716, 15.853, P=0.001, 0.001,0.001<0.05). There was a significant positive correlation between ultrasound scores of patients in the active group and TNF-α, CRP, and DAS28 scores. After ROC curve analysis, the specificity of patients diagnosed by ultrasound score was83.65%, and the sensitivity was 88.93%. Conclusion Myoskeletal ultrasound has important application value in the evaluation of rheumatoid arthritis. It can effectively evaluate patients in active or remission stage, and has clinical application value.