超声诊断痛风性关节炎的临床价值

Clinical value of ultrasound in the diagnosis of gouty arthritis

目的研究超声诊断痛风性关节炎(GA)的临床价值。方法选择120例GA患者作为研究组,另选取同期具有类似症状的其他疾病患者作为对照组(100例),两组均接受超声检查,比较两组患者受累关节情况及关节病变处的超声表现。同时根据病情将研究组分为急性GA组和慢性GA组,观察两组患者关节滑膜内及其周边血流情况。结果研究组与对照组患者肩关节、膝关节、踝关节、腕关节、第一跖趾关节受累情况比较,差异均无统计学意义(均P>0.05)。研究组与对照组患者的骨侵蚀、关节腔内高回声点以及软组织肿胀发生率比较差异无统计学意义(均P>0.05),但研究组患者痛风石、周围肌腱内高回声点以及平行线发生率显著高于对照组(均P<0.05)。急性GA组血流分级水平及血流信号检出率显著高于慢性GA组(均P<0.05)。结论超声诊断GA患者可观察到痛风石、平行线、周围肌腱内高回声点等影像学特征,同时可利用彩色多普勒血流信号变化,为临床诊断疾病活动性提供客观科学的依据。

Objective To study the clinical value of ultrasound in the diagnosis of gouty arthritis(GA).Methods A total of 120 GA patients were selected as the study group,and 100 other diseases patients with similar symptoms were selected as the control group during the same period.Both groups received ultrasound examination,and the condition of the joints involvement and the ultrasonic manifestations of the joint lesions were compared between the two groups;meanwhile,the study group was divided into acute GA group and chronic GA group,and the blood flow in and around the synovium of joint were observed in the two groups.Results There were no statistically significant differences in the shoulder joint,knee joint,ankle joint,wrist joint and the first metatarsophalangeal joint involvement between the study group and the control group(all P>0.05).There were no statistically significant differences in the incidence of bone erosion,hyperechoic points of intra-articular and soft tissue swelling between the study group and the control group(all P>0.05);however,the incidences of gout stone,hyperechoic points in the surrounding tendons and parallel lines in the study group were significantly higher than those in the control group(all P<0.05).The level of blood flow classification and detection rate of blood flow signal in the acute GA group were significantly higher than those in the chronic GA group(all P<0.05).Conclusion Ultrasound diagnosis of GA patients can observe the gout stone,parallel lines,hyperechoic points in the surrounding tendons and other imaging features;meanwhile,color Doppler blood flow signal changes can be used to provide the objective and scientific basis for clinical diagnosis of disease activity.