超声下附着点炎评分在外周型脊柱关节炎诊断中的价值

Value of ultrasound enthesitis score in the diagnosis of peripheral spondyloarthritis

目的探讨超声下附着点炎评分在外周型脊柱关节炎诊断中的应用价值。方法选取2021年1月至2023年2月海南医学院第一附属医院风湿免疫科门诊及病房收治的外周型脊柱关节炎(peripheral spondyloarthritis,pSpA)和类风湿关节炎(rheumatoid arthritis,RA)患者,本院健康工作人员为对照组。采用多普勒超声检查7对肌腱附着点,比较三组人群超声下附着点炎评分。采用受试者工作特征曲线分析超声下附着点炎评分在诊断pSpA中的价值。结果共纳入pSpA组49例、RA组41例和对照组30例。超声下附着点炎的阳性率在pSpA组及RA组中差异无统计学意义(P<0.05)。pS-pA组及RA组超声下附着点炎的阳性率均显著高于对照组(P<0.05)。超声下附着点炎评分在pSpA组显著高于RA组及对照组(P<0.05)。超声下附着点炎评分(≥6.5分)在诊断pSpA中的敏感性和特异性分别为80.6%和60.7%;当与RA相鉴别时,超声下附着点炎评分(≥6.5分)在诊断pSpA中的敏感性和特异性分别为70.6%、62.5%。结论超声下附着点炎评分有助于pSpA的诊断及其与RA的鉴别诊断。

Objective To explore the value of ultrasonographic enthesitis score in the diagnosis of peripheral spondyloarthritis(pSpA).Methods Patients with pSpA and rheumatoid arthritis(RA)admitted to the outpatient clinic and hospitalized in the Rheumatology and Immunology Department of the First Affiliated Hospital of Hainan Medical University from January 2021 to February 2023 were selected.The healthy staff in our hospital were as the negative control(NC)group.Seven pairs of entheses were examined by Doppler ultrasound,and the enthesitis scores were compared among the three groups.Receiver operating characteristic curve analysis was used to evaluate the ultrasonographic enthesitis score in the diagnosis of pSpA.Results A total of 49 patients with pSpA,4l patients with RA,and 30 in NC group were enrolled in this study.The positive rates of ultrasonographic enthesitis in the pSpA and RA groups were significantly higher than those in the NC group(P<o.05).There was no significant difference between the pSpA group and the RA group.The ultrasonographic enthesitis score was significantly higher in the pSpA group than that in the RA and NC groups(P<0.05).The sensitivity and specificity of ultrasonographic enthesitis score(≥6.5 points)in diagnosing pSpA were 80.6%and 60.7%,respectively.When differentiated from RA,the sensitivity and specificity of ultrasonographic enthesitis score(≥6.5 points)in diagnosing pSpA were 70.6%and 62.5%,respectively.Conclusion The ultrasonographic enthesitis score helps in the diagnosis of pSpA and its differentiation from rheumatoid arthritis.