观察非布司他治疗痛风性关节炎的疗效及治疗前后患者受累关节彩色超声图像的变化

Observation on the efficacy of febuxostat in the treatment of gouty arthritis and the change of color ultrasound images of affected joints before and after treatment

目的:观察非布司他治疗痛风性关节炎的疗效及治疗前后患者受累关节彩色超声图像变化。方法:2018年7月-2019年8月收治痛风性关节炎患者72例,随机分为两组,各36例。观察组采取非布司他片治疗;对照组采取别嘌醇片治疗。比较两组治疗效果。结果:观察组治疗2周、4周、8周后血尿酸水平均明显低于对照组,差异有统计学意义(P<0.05)。观察组治疗后高密度脂蛋白、低密度脂蛋白及甘油三酯等指标水平均显著低于对照组,差异有统计学意义(P<0.05)。治疗后,所有患者受试关节的0级双轨征、滑膜增厚、关节积液及血液显像比例均明显升高;1级、2级、3级双轨征、滑膜增厚、关节积液及血液显像比例均降低;肌腱周围强回声、暴雪样回声比例均显著降低,差异有统计学意义(P<0.05)。结论:痛风性关节炎采取非布司他治疗,能够有效降低患者血尿酸水平,改善血脂水平。同时治疗后患者关节双轨征、滑膜增厚、肌腱周围强回声、关节积液、关节液内暴雪样回声减少,患者关节血流信号减弱。

Objective:To observe the curative effect of febuxostat in the treatment of gouty arthritis and the changes of color ultrasound image of affected joints before and after treatment.Methods:From July 2018 to August 2019,72 cases of patients with gouty arthritis were enrolled,they were randomly divided into two groups with 36 cases in each group.The observation group was treated with febuxostat and the control group was treated with allopurinol.The therapeutic effects between the two groups was compared.Results:The serum uric acid levels in observation group was significantly lower than that in control group after 2,4 and 8 weeks of treatment,the differences were statistically significant(P<0.05).After treatment,the levels of HDL,LDL and TG in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the patients tested joints with grade 0 double track sign,synovial thickening,joint effusion and blood imaging ratios were significantly increased;grade 1,grade 2,and grade 3 double track sign,synovial thickening,joint effusion The proportions of imaging and blood imaging were reduced;the proportions of strong echoes around tendons and Blizzard-like echoes were significantly reduced,and the difference was statistically significant(P<0.05).Conclusion:The treatment of gouty arthritis with febuxostat can effectively reduce the serum uric acid level and improve the blood lipid level of patients.At the same time,it can promote the reduction of the patient's joint double-track sign,synovial thickening,strong echo around the tendon,joint effusion,and Blizzard-like echo in the joint fluid,and can also weaken the patient's joint blood flow signal.