超声评价类风湿性关节炎疾病活动性的价值

The value of ultrasound in evaluating rheumatoid arthritis disease activity

目的:探讨超声在类风湿性关节炎(rheumatoid arthritis,RA)患者手关节滑膜病变中的应用价值。方法:选取2019年4—12月汕头大学医学院第一附属医院32例RA患者,其中男性9例,女性23例,年龄39~62(46.8±6.4)岁。应用灰阶超声及彩色多普勒血流成像扫查RA患者双手第1~5掌指关节与腕关节,观察关节滑膜厚度和血流信号情况,进行半定量评分。分析RA患者年龄、病程及生化指标与超声评分的相关性。结果:RA患者掌指关节及腕关节滑膜增生的检出率分别是21.25%、53.12%,掌指关节、腕关节血流信号阳性的检出率分别是14.69%、31.25%,腕关节滑膜增生和血流信号阳性检出率比掌指关节的高(均P<0.05)。红细胞沉降率、C反应蛋白、抗环瓜氨酸肽抗体与关节滑膜血流信号积分之间呈正相关(r值分别是0.62、0.54、0.54,均P<0.05)。结论:红细胞沉降率、C反应蛋白、抗环瓜氨酸肽抗体与RA关节滑膜血流信号积分之间有相关性。超声常规检查的半定量研究可作为评估RA疾病活动性的参考。

Objective:To investigate the value of ultrasound in synovial lesions of the hand joints in patients with rheumatoid arthritis(RA).Methods:Thirty-two RA patients,including 9 males and 23 females,aged 39-62(46.8±6.4)years old,were selected from the First Affiliated Hospital of Shantou University Medical College from April 2019 to December 2019.Gray-scale ultrasound and color Doppler flow imaging were applied to scan the 1st to 5th metacarpophalangeal joints and wrist joints of both hands of RA patients,and the synovial thickness and blood flow signals of the joints were observed and semi-quantitative scoring was performed.The correlation between age,disease duration and biochemical indexes and ultrasound scores of RA patients were analyzed.Results:The detection rates of synovial hyperplasia in the metacarpophalangeal joints and wrist joints of RA patients were 21.25%and 53.12%,respectively,and the detection rates of positive blood flow signals in the metacarpophalangeal joints and wrist joints were 14.69%and 31.25%,respectively,and the detection rates of synovial hyperplasia and positive blood flow signals in the wrist joints were higher than those in the metacarpophalangeal joints(all P<0.05).There was a positive correlation between erythrocyte sedimentation rate,C-reactive protein,anticyclic citrullinated peptide antibody and synovial blood flow signal score(r values were 0.62,0.54,0.54,respectively,all P<0.05).Conclusion:There is a correlation between erythrocyte sedimentation rate,C-reactive protein,anticyclic citrullinated peptide antibody,and RA synovial blood flow signal score.Semi-quantitative studies of routine ultrasound examinations may serve as a reference for assessing RA disease activity.