7关节超声半定量评分评估类风湿关节炎疾病活动度

Value of 7-joint ultrasound semi-quantitative score in the evaluation of rheumatoid arthritis disease activity

目的:探讨7关节超声(US7)半定量评分评估类风湿关节炎(RA)疾病活动度的效果。方法:选取37例RA病人,根据超敏C反应蛋白(hs-CRP)水平将RA病人分为hs-CRP正常组(n=14)与hs-CRP升高组(n=23),对2组病人病变严重侧腕关节,第2、3掌指关节,第2、3近端指间关节,第2、5跖趾关节行灰阶超声和能量多普勒超声检查并进行评分,比较2组间评分差异,并分析US7评分与hs-CRP之间的相关性。结果:hs-CRP升高组滑膜增生、滑膜血流评分及US7总分均高于hs-CRP正常组(P<0.05~P<0.01),2组间关节积液、骨质侵蚀评分差异均无统计学意义(P>0.05)。37例RA病人中,US7的滑膜血流、骨质侵蚀、US7总分与hs-CRP水平均呈正相关关系(P<0.01);滑膜增生、关节积液与hs-CRP水平均无明显相关关系(P>0.05)。结论:US7评分可以评估RA的疾病活动度,是监测RA疾病活动度简单、有效的影像学检查方法。

Objective:To investigate the value of ultrasonic semi-quantitative scoring of 7 joints(US7)in the evaluation of the rheumatoid arthritis(RA)disease activity.Methods:Thirty-seven patients with RA were divided into the hypersensitive C-reactive protein(hs-CRP)normal group(14 cases)and hs-CRP increasing group(23 cases)according to the level of hs-CRP.The severe side wrist joint,second and third metacarpophalangeal joints and proximal interphalangeal joints,and second and fifth metatarsophalangeal joints in two groups were examined by gray-scale ultrasound and energy Doppler ultrasound.The scores were compared between two groups,and the correlation between US7 score and hs-CRP was analyzed.Results:The synovial hyperplasia,synovial blood flow scoring and total US7 score in hs-CRP increasing group were higher than those in hs-CRP normal group(P<0.05 to P<0.01).The differences of the scores of joint effusion and bone erosion between two groups were not statistically significant(P>0.05).Among the 37 RA patients,the synovium blood flow,bone erosion and US7 total score were positively correlated with the level of hs-CRP.The synovial hyperplasia and joint effusion were not correlated to the level of hs-CRP(P>0.05).Conclusions:The US7 score can be used to evaluate the disease activity of RA,and it is a simple and effective imaging method to monitor the disease activity of RA.