寻常性银屑病亚临床关节炎的临床研究

A clinical study of subclinical arthritis in patients with psoriasis vulgaris

目的初步研究寻常性银屑病患者亚临床关节炎的发生率、临床特征及实验室指标,分析寻常性银屑病患者发生亚临床关节炎可能的相关危险因素,为临床识别早期关节性银屑病提供参考。方法根据入排标准筛出50例寻常性银屑病患者,并对其双肘关节、双膝关节和双踝关节及跟腱进行高频超声检查,其中超声结果异常者再行磁共振成像(MRI)检查,确认存在亚临床关节炎症改变。对10例有关节炎(有亚临床关节炎组)和40例无关节炎(无亚临床关节炎组)受试者的临床特征和实验室指标进行统计学分析。结果寻常性银屑病患者亚临床关节炎的发生率为20%。临床特征中,有亚临床关节炎组患者的年龄(P=0.000)、银屑病病程(P=0.004)、皮损初发年龄(P=0.001)、有吸烟史(P=0.010)明显高于无亚临床关节炎组患者。两组患者在实验室指标方面差异无统计学意义。寻常性银屑病患者发生亚临床关节炎可能的影响因素是患者年龄(OR=1.185,P=0.001)、银屑病病程(OR=1.119,P=0.010)、皮损初发年龄(OR=1.113,P=0.006)。结论寻常性银屑病患者中亚临床关节炎的发生率低。年龄、银屑病病程、皮损初发年龄可能是寻常性银屑病患者发生亚临床关节炎的危险因素。

Objective To preliminarily investigate the prevalence,clinical features and laboratory indexes of subclinical arthritis in patients with psoriasis vulgaris.The possible risk factors related to subclinical arthritis were analyzed,so as to provide reference for identification of early psoriatic arthritis.Methods A total of 50 patients with psoriasis vulgaris were selected based on the grouping exclusive criteria,and all the elbow joints,knee joints,ankles and the Achilles tendons of the patients were examined by power doppler ultrasonography,then the abnormities found by doppler ultrasonography were furtherly examined by MRI.The clinical data and laboratory indexes of the subjects with(10 cases)or without arthritis(40 cases)were statistically analyzed.Results The incidence of subclinical arthritis in psoriasis was 20%.Age(P=0.000),length of course(P=0.004),age of onset of skin lesions(P=0.001),and the number of patients with a history of smoking(P=0.010)of patients with subclinical arthritis were higher than those without subclinical arthritis.There was no significant difference in laboratory parameters between the two groups.Age(OR=1.185,P=0.001),length of course(OR=1.119,P=0.010),age of onset of skin lesions(OR=1.113,P=0.006)may be the risk factors for subclinical arthritis.Conclusion The prevalence of subclinical joint injury in patients with psoriasis was low.Age,length of course,age of onset of skin lesions may be the risk factors for subclinical arthritis in patients with psoriasis vulgaris.