血友病性关节病患者滑膜厚度与血友病关节健康状况评分相关性的研究

Correlation between synovial thickness and HJHS in patients with hemophilic arthropathy

目的探讨血友病性关节病(hemophiliac arthropathy,HA)患者超声检测关节滑膜厚度与血友病关节健康状况(hemophilia joint health score,HJHS)评分的相关性。方法回顾性分析2016年1月至2018年11月,在我院就诊的42例血友病患者行超声探查关节滑膜厚度情况,参照HJHS 2.1版对患者关节进行血友病关节健康评分,采用Pearson相关系数分析两者之间的相关性。本组42例,根据年龄分为两组,≤18岁为青少年组,>18岁为成人组。应用SPSS 17.0,分析两组患者的滑膜厚度和HJHS评分的差异。结果(1)42例(252个关节),滑膜增生为Ⅰ级占12.30%,Ⅱ级占37.30%,Ⅲ级占29.37%,Ⅳ级占21.03%;(2)HJHS评分结果显示:总评分最低0分,最高80分,平均(21.24±21.52)分;(3)42例关节滑膜厚度为(54.02±29.22)mm,HJHS总评分为(21.24±21.52)分,两组数据存在显著相关性(r=0.95,P<0.001);(4)青少年组与成人组的HJHS总评分分别为(6.90±9.48)分和(35.57±20.70)分,组间比较差异有统计学意义(t=5.77,P<0.001);青少年组与成人组的滑膜总厚度分别为(21.16±10.11)mm和(43.75±15.13)mm,组间比较差异有统计学意义(t=5.69,P<0.001)。结论血友病性关节炎严重影响患者的生活质量,超声检查和HJHS评分是评价血友病患者关节健康情况的有效指标。

Objective To explore the correlation between synovium thickness and hemophilia joint health score(HJHS)in patients with hemophilia arthropathy(HA).Methods The synovium thickness of 42 HA patients,from January 2016 to November 2018,were retrospectively analyzed.The joint health was scored according to HJHS 2.1.The correlation between synovium thickness and HJHS was analyzed by Pearson correlation coefficient andSPSS 17.0.All patients were divided into two groups according to the age:adolescent group(≤18 years);adult group(>18 years).Results(1)Ultrasound results(252 joints of 42 patients):synovial hyperplasia grade I 12.30%;grade II 37.30%;grade III 29.37%;grade IV 21.03%.(2)HJHS:the lowest score was 0;the highest score was 80;the average score was(21.24±21.52).(3)The synovial thickness was(54.02±29.22)mm;the total HJHS was(21.24±21.52);significant correlation between the two groups(r=0.95,P<0.001).(4)The total HJHS of the adolescent group and the adult group were(6.90±9.48)and(35.57±20.70),and the differences between the two groups were statistically significant(t=5.77,P<0.001);The total thickness of the synovial membrane of the adolescent group and the adult group were(21.16±10.11)mm and(43.75±15.13)mm,and the differences between the two groups were statistically significant(t=5.69,P<0.001).Conclusions HA seriously affects the quality of life.Ultrasonography and HJHS are effective indicators to evaluate the joint health of HA patients.