肌骨超声检查在急性痛风性关节炎诊断及病情评估中的应用价值

Application value of musculoskeletal ultrasonography in diagnosis and disease assessment of acute gouty arthritis

目的探究肌骨超声检查在急性痛风性关节炎(GA)诊断及病情评估中的应用价值。方法将2020年1月至2021年12月在西安市中医医院以及铜川市人民医院就诊的87例GA患者作为研究组,将同期81例其他类型关节炎患者作为对照组。两组均接受肌骨超声检查。比较两组患者的肌骨超声关节部位及超声表现;比较两组患者的肌骨超声半定量、视觉模拟评分法(VAS)、疾病活动指数(DAI)评分;分析肌骨超声各项表现对GA的诊断效能。结果研究组的双轨征、痛风石、高回声点检出率显著高于对照组,骨侵蚀、腱鞘炎检出率显著低于对照组,差异具有统计学意义(P<0.05)。研究组的肌骨超声半定量、VAS、DAI评分均显著高于对照组,差异具有统计学意义(P<0.05)。肌骨超声检查中双轨征、痛风石、高回声点三项超声表现联合诊断GA的曲线下面积(AUC)为0.814,灵敏度为70.1%,特异度为92.6%,Kappa系数为0.622,具有较强一致性。结论肌骨超声检查可作为GA临床诊断及病情评估的可靠方法,值得推广和应用。

Objective To explore the application value of musculoskeletal ultrasonography in diagnosis and disease assessment of acute gouty arthritis(GA).Methods A total of 87 GA patients treated in Xi'an Hospital of Traditional Chinese Medicine and People's Hospital of Tongchuan from January 2020 to December 2021 were included as study group,and 81 patients with other types of arthritis were included as control group.Both groups received musculoskeletal ultrasonography.The musculoskeletal ultrasonography joint sites and ultrasonic manifestations were compared between the two groups;the scores of semi-quantitative musculoskeletal ultrasonography,Visual Analogue Scale(VAS)and Disease Activity Index(DAI)were compared between the two groups;the diagnostic efficacy of musculoskeletal ultrasonography in GA was analyzed.Results The detection rates of double-track sign,tophus and high echo point in the study group were significantly higher than those in the control group,the detection rates of bone erosion and tenosynovitis were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The semi-quantitative musculoskeletal ultrasonography,VAS and DAI scores in the study group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The area under curve(AUC)of the combined diagnosis of double-track sign,tophus and high echo point in musculoskeletal ultrasonography was 0.814,the sensitivity was 70.1%,the specificity was 92.6%,and the Kappa coefficient was 0.622,with strong consistency.Conclusion Musculoskeletal ultrasonography can be as a reliable method for clinical diagnosis and disease assessment of GA,which is worthy of promotion and application.