肌骨超声半定量技术与类风湿关节炎疾病活动度的相关性分析

Correlation Analysis Between Musculoskeletal Ultrasound Semi-Quantitative Technology and Disease Activity of Rheumatoid Arthritis

目的分析肌骨超声半定量技术对类风湿关节炎患者病情活动度的相关影响因素,探讨肌骨超声半定量技术的临床应用价值。方法选取2021年6月至2022年5月间于秦皇岛市第一医院确诊为类风湿关节炎的96例患者为研究对象,将入组患者按照疾病活动度评分(Disease Activity Score 28,DAS28)方法分为轻度活动受限组(2.63.2),其中轻度活动受限组44例、中重度活动受限组52例。记录患者肌骨超声半定量评分中关节积液、滑膜内增生、滑膜内血流及骨侵蚀得分情况,并对患者的临床指标进行统计分析,包括类风湿因子(Rheumatoid Factor,RF)、血小板(Platelet,PLT)、C反应蛋白(C-Reactive Protein,CRP)和红细胞沉降率(Erythrocyte Sedimentation Rate,ESR),分析肌骨超声半定量评分同临床指标的相关性。并运用受试者工作特征(Receiver Operating Characteristic,ROC)曲线对肌骨超声半定量评分、RF、PLT、CRP、ESR在类风湿关节炎疾病活动度中的评估价值进行分析。结果肌骨超声半定量评分结果显示,轻度活动受限组的关节积液、滑膜内增生、滑膜内血流、骨侵蚀评分及半定量评分总分均显著低于中重度活动受限组,差异具有统计学意义(P<0.05);血清学指标结果显示,轻度活动受限组的RF、PLT、CRP、ESR水平均显著低于中重度活动受限组,差异具有统计学意义(P<0.05);肌骨超声半定量评分同RF、PLT、CRP、ESR水平间呈明显正相关性(r=0.487、0.396、0.295、0.543,P<0.05);ROC曲线结果显示,肌骨超声半定量评分、RF、PLT、CRP、ESR水平对类风湿关节炎疾病活动度评估的曲线下面积为0.696~0.913。结论肌骨超声半定量评分对类风湿关节炎患者的疾病活动度有较高的评估价值,为临床的诊疗提供了新的思路,值得在临床中推广使用。

Objective To analyze the relevant influencing factors of musculoskeletal ultrasound semi-quantitative technology on the disease activity of patients with rheumatoid arthritis,and to explore the clinical application value of musculoskeletal ultrasound semi-quantitative technology.Methods A total of 96 patients diagnosed with rheumatoid arthritis in First Hospital of Qinhuangdao from June 2021 to May 2022 were selected as the study objects,and according to disease activity score 28(DAS28)method,the enrolled patients were divided into mild limited activity group(2.6<DAS≤3.2)and moderate to severe limited activity group(DAS>3.2),of which 44 cases were mild limited activity group and 52 cases were moderate to severe limited activity group.The scores of joint effusion,synovial hyperplasia,synovial bloodflow and bone erosion in the musculoskeletal ultrasound semi-quantitative score of the patients were recorded,and the clinical indicators of the patients were statistically analyzed,including rheumatoid factor(RF),platelet(PLT),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR).The correlation between musculoskeletal ultrasound semi-quantitative score and the clinical indicators was analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the value of musculoskeletal ultrasound semi-quantitative score,RF,PLT,CRP and ESR in the disease activity of rheumatoid arthritis.Results The results of musculoskeletal ultrasound semi-quantitative score showed that the scores of joint effusion,synovial hyperplasia,synovial bloodflow,bone erosion and the total score of semi-quantitative score in the mild limited activity group were significantly lower than those in the moderate to severe limited activity group,with statistical significance(P<0.05).The serological index results showed that the levels of RF,PLT,CRP and ESR in the mild limited activity group were significantly lower than those in the moderate to severe limited activity group,with statistical significance(P<0.05).There was a significant positive correlation between the musculoskeletal ultrasound semi-quantitative score and the levels of RF,PLT,CRP and ESR(r=0.487,0.396,0.295,0.543;P<0.05).The ROC curve results showed that the area under the curve of musculoskeletal ultrasound semi-quantitative score,RF,PLT,CRP and ESR levels for the disease activity assessment of rheumatoid arthritis ranged from 0.696 to 0.913.Conclusion Musculoskeletal ultrasound semi-quantitative score is more accurate in evaluating the disease activity of patients with rheumatoid arthritis,which provides a new idea for clinical diagnosis and treatment,and is worth promoting in the future clinical application.