摘要
目的:比较寒湿痹阻及湿热痹阻型类风湿性关节炎(Rheumatoid arthritis,RA)的腕关节在MRI上表现的差异,为RA的中医辨证提供较为客观的依据。方法 :收集70例辨证属寒湿痹阻型或湿热痹阻型RA的患者,并分为早期组(病程≤24月)及中晚期组(病程>24月),以MRI检查观察腕关节的滑膜增厚、血管翳强化、骨侵蚀、骨髓水肿、关节积液及腱鞘炎的发现情况,并进行比较。结果:湿热痹阻型RA早期组血管翳强化及骨侵蚀的发生率较寒湿痹阻型早期组显著增高(P均<0.01),而滑膜增厚、骨髓水肿、关节积液及腱鞘炎的发生率间的差异无统计学意义(P均>0.05);寒湿痹阻型及湿热痹阻型RA中晚期组滑膜增厚、血管翳强化、骨侵蚀、骨髓水肿、关节积液及腱鞘炎的发生率间的差异均无统计学意义(P均>0.05)。寒湿痹阻型及湿热痹阻型RA早期组及中晚期组上述指标间比较均无统计学差异(P均>0.05)。结论:MRI检查RA早期患者腕关节的血管翳及骨侵蚀在一定程度上可以为中医辨证寒湿痹阻型及湿热痹阻型RA提供参考依据。
Objective:To compare the differences of wrist joint magnetic resonance imaging(MRI)manifestations of rheumatoid arthritis(RA)with syndrome of stagnation of damp-heat and RA with syndrome of stagnation of cold-damp,so as to provide objective basis for TCM syndrome differentiation of rheumatoid arthritis.Methods:Seventy cases of RA patients with syndrome of stagnation of damp-heat or syndrome of stagnation of cold-damp were collected,both two group patients were seperately divided into early stage group(≤24 months)and middle-late group(>24 months).MRI was applied to detect and compare the changes of MRI feathers,such as polyarticular synovial hyperplasia,pannus enhancement,bone erosion,bone marrow edema,joint effusion and tenosynovitis.Results:The occurrence of pannus enhancement and bone erosion were significantly higher in early stage of hot syndrome than that in early stage of cold syndrome(both P<0.01).While,there was no statistical difference in the incidence of polyarticular synovial hyperplasia and bone marrow edema,joint effusion and tenosynovitis between the two groups(all P>0.05).There was no statistical difference in the incidence of polyarticular synovial hyperplasia and pannus enhancement,bone erosion and bone marrow edema,joint effusion and tenosynovitis between the two groups in middle-late stage(all P>0.05).There was no statistical difference in the above indexes between the early stage and middle-late stage of those two syndrome of RA(all P>0.05).Conclusion:MRI features changes such as pannus enhancement and bone erosion on wrist in the early stage of RA can provide references for differentiation of stagnation of damp-heat and stagnation of cold-damp in Chinese medical syndrome.
作者
孙轶
耿进朝
赵书英
王义军
SUN Yi;GENG Jin-chao;ZHAO Shu-ying;WANG Yi-jun(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)
出处
《中国临床医学影像杂志》
CAS
2019年第4期271-275,共5页
Journal of China Clinic Medical Imaging
基金
中国中医科学院自主选题研究项目(Z20908012)
关键词
关节炎
类风湿
腕关节
磁共振成像
Arthritis,rheumatoid
Wrist joint
Magnetic resonance imaging