摘要
目的:研究超微血管成像技术(SMI)半定量分级与类风湿关节炎(RA)患者骨代谢情况的相关性。方法:选取2017年3月至2018年7月在我院诊断为类风湿性关节炎(RA)的病人131例。根据DAS28结果将病人分为疾病缓解期(20例)、轻度活动期(41例)、中度活动期(46例)及重度活动期(24例)4组。超声SMI模式评估各组患者关节滑膜内血流信号。全自动生化分析仪检测患者血清中骨形成标志物骨保护素(OPG)、I型前胶原氨基端前肽(PINP)、I型前胶原羧基端前肽(PICP)、I型胶原C端肽(CTX-I)、抗酒石酸酸性磷酸酶5b(TRACP5B)及骨碱性磷酸酶(BALP)的水平。对不同疾病程度RA患者SMI半定量评分和各标志物水平进行单因素方差分析,同时分析SMI半定量评分与DAS28及各标志物的相关性。结果:疾病活动度高组的患者SMI半定量分级评分明显高于活动度低组患者(F=97.516,P<0.01)。疾病活动度高的患者OPG(F=51.292,P<0.01)、PINP(F=102.545,P<0.01)、PICP(F=144.512,P<0.01)、BALP(F=178.535,P<0.01)水平明显高于活动度低组患者(均P<0.05),疾病活动度高组患者CTX-I(F=30.450,P<0.01)和TRACP5B(F=118.151,P<0.01)水平明显低于活动度低组患者,且两两之间有显著性差异(均P<0.01)。相关性分析显示,SMI半定量评分与DAS28正相关(R^2=0.4862,P<0.01),与OPG(R^2=0.3725,P<0.01)、PINP(R^2=0.4842,P<0.01)、PICP(R^2=0.4857,P<0.01)、BALP(R^2=0.4759,P<0.01)负相关,与CTX-I(R^2=0.2374,P<0.01)和TRACP5B(R^2=0.4375,P<0.01)正相关。结论:SMI分级随RA患者疾病活动程度加重而升高,并且与骨代谢状态相关。
Objective:To study the relationship between semi-quantitative scoring of superb microvascular imaging and markers of bone metabolism in patients with rheumatoid arthritis.Methods:A total of 131 patients diagnosed with rheumatoid arthritis(RA)in our hospital from March 2017 to July 2018 were enrolled in this study.According to the DAS28 scores,patients were divided into 4 groups:remission group(20 patients),mild-active group(41 patients),moderate-active group(46 patients)and severe-active group(24 patients).The synovial flow signals were provided by the superb microvascular imaging(SMI)pattern of ultrasound.Patients were graded by SMI semi-quantitative scoring.Moreover,the serum levels of osteoprotegerin(OPG),procollagen type I N-terminal propetide(PINP),propeptide of type I procollagen(PICP),carboxy-terminal telopeptide of type I collagen(CTX-I),tartrate-resistant acid phosphatase 5B(TRACP5B)and bone alkaline phosphatase(BALP)were detected.The SMI scores and the level of these six markers of the 4 groups were compared.The relationship of SMI with DAS28 score and levels of the six markers were analyzed by Pearson correlation analysis.Results:The SMI scores in patients with high disease activity were higher than those in patients with low disease activity(F=97.516,P<0.01).The levels of OPG(F=51.292,P<0.01),PINP(F=102.545,P<0.01),PICP(F=144.512,P<0.01),BALP(F=178.535,P<0.01),CTX-I(F=30.450,P<0.01)and TRACP5 B(F=118.151,P<0.01)in patients with high disease activity were lower than those in patients with low disease activity.Correlation analysis showed that the SMI score was negatively correlated with the level of OPG(R^2=0.3725,P<0.01),PINP(R^2=0.4842,P<0.01),PICP(R^2=0.4857,P<0.01),BALP(R^2=0.4759,P<0.01),and positively correlated with DAS28 scores and the level of CTX-I(R^2=0.2374,P<0.01)and TRACP5 B(R^2=0.4375,P<0.01).Conclusion:The SMI grades of RA patients increase with patients’disease activity,and are correlated with bone metabolism.
作者
李风娟
晋秀丽
杜建文
王洪
白静
LI Fengjuan;JIN Xiujuan;DU Jianwen;WAND Hong;BAI Jing(Ultrasonic Diagnosis Department,the Central Hospital of Chengde,Chengde 061000,China;UItrasonic Diagnosis Department,the Third Hospital of Chengde,Chengde 067000,China)
出处
《现代医学》
2020年第9期1112-1117,共6页
Modern Medical Journal
基金
承德市科学技术与发展计划(201804A014)。
关键词
超微血管成像
类风湿关节炎
骨代谢
相关性
superb microvascular imaging
rheumatoid arthritis
bone metabolism
correlation