痛风性关节炎患者第一跖趾关节尿酸盐负荷的评估及预测

Assessment and Prediction of the First Metatarsophalangeal Urate Load in Gouty Arthritis

目的基于2021年风湿病临床试验预后评价痛风工作组的超声半定量评分系统(SQUS)对痛风患者第一跖趾关节(MTP1)评分(SQUS-MTP1),以评估尿酸盐负荷,并分析尿酸盐负荷的影响因素和尿酸盐沉积的独立危险因素。资料与方法前瞻性研究2020年9月—2021年11月于川北医学院附属医院确诊的192例痛风性关节炎患者,超声检查双下肢关节的特征性痛风征象,评估双侧MTP1尿酸盐负荷,分析尿酸盐负荷的影响因素及尿酸盐沉积的独立危险因素。结果痛风病程、年龄、血清尿酸(SUA)与MTP1尿酸盐负荷的多元线性回归分析差异均有统计学意义,建立回归模型MTP1尿酸盐负荷=-13.29+0.18×病程+0.05×年龄+0.03×SUA。SUA(OR=1.010)与SQUS-MTP1分组的二元Logistic回归分析差异有统计学意义。结论联合痛风病程、年龄、SUA能初步预测痛风性关节炎患者MTP1尿酸盐负荷;SUA升高是痛风性关节炎患者MTP1尿酸盐沉积的独立危险因素。

Purpose To assessed urate load in gouty arthritis by scoring bilateral the first metatarsophalangeal(MTP1)gout lesions using semi-quantitative ultrasound scoring system(SQUS)of outcome measures in rheumatology clinical trials in 2021 for gout lesions,to analyze factors influencing urate load,and to identify the independent risk factors for the development of urate deposits.Materials and Methods This study was a prospective study.From September 2020 to November 2021,192 patients with gouty arthritis diagnosed in Affiliated Hospital of North Sichuan Medical College were selected via ultrasound examination of gout lesions in both lower limb joints to assess bilateral MTP1 urate load and to analyze the factors influencing urate load and independent risk factors for urate deposition.Results Disease duration,age,serum urate(SUA)and MTP1 urate load were statistically significant factors via multiple linear regression analysis.And a regression model of MTP1 urate load=-13.29+0.18×disease duration+0.05×age+0.03×SUA was established.Binary Logistic regression of SUA(OR=1.010)with SQUS-MTP1 subgroup analysis was statistically significant.Conclusion The duration of gout,age and SUA can initially predict the MTP1 urate load in gouty arthritis.Elevated SUA may be the independent risk factor for the development of urate deposition in MTP1 in gouty arthritis.