彩色超声评估活动期强直性脊柱炎患者骶髂关节炎和肌腱端病变的价值  

The evaluating value of color ultrasound for sacroiliitis and enthesopathy in ankylosing spondylitis

作　　者：薛勤[1] 朱家安[2] 汪年松[1] 张晓光[1] 高许萍[1] 范瑛[1] 

机构地区：[1]上海交通大学附属第六人民医院肾脏风湿科,200233 [2]上海交通大学附属第六人民医院超声科,200233

出　　处：《实用医学杂志》2010年第10期1759-1761,共3页The Journal of Practical Medicine

基　　金：上海市卫生局科研课题资助项目(编号:2009092)

摘　　要：目的:探讨彩色多普勒超声评价活动性强直性脊柱炎(ankylosing spondylitis,AS)患者骶髂关节炎和肌腱端病变中的价值。方法:对比30例健康志愿者和50例AS患者的彩色多普勒高频声像和血流情况,活动期及非活动期AS患者病变部位的高频声像和血流的改变,并与血沉、C反应蛋白和Bath AS疾病活动指数等作对比分析。结果:与健康志愿者比较AS患者骶髂关节、跟腱附着端、髌韧带附着端、股直肌肌腱附着端超声检查阳性率比较差异有显著性(P<0.05)。Bath AS疾病活动性指数(BASDAI)≥4的患者在外周肌腱端阳性率较BASDAI<4差异有显著性(P<0.05),并在Bath AS功能指数、患者总体评价VAS、夜间背痛和总体背痛VAS、晨僵时间、ESR、CRP均较BASDAI<4差异有显著性(P<0.05)。结论:超声能敏感地发现关节滑膜和肌腱端病变的变化情况,从而间接地反映炎症程度,可用于活动性AS患者病情的追踪和临床疗效的评价。Objective To explore the value of color Doppler ultrasound in evaluating sacroiliitis and enthesopathy in patients with active ankylosing spondylitis （AS）. Methods Color Doppler high-frequency ultrasound images and blood flow were compared between 30 healthy volunteers and 50 AS patients,and between active AS patients and non-active AS patients. The changes of erythrocyte sedimentation rate （ESR）,C-reactive protein （CRP）,and the Bath AS disease activity index were analyzed. Results Positive rates in sacroiliac joints,achilles tendon attachments,patellar ligament attachments,and rectus femoris tendon attachments were significantly different between AS patients and healthy volunteers （P 0.05）. There were significant difference in positive rate of peripheral tendon attachments,Bath AS functional index （BASFI）,patient＇s global assessment VAS （PGA）,nocturnal back pain and general back pain VAS,morning stiffness duration,ESR and CRP between patients with Bath AS disease activity index （BASDAI） not less than 4 and those with BASDAI less than 4 （P 0.05）. Conclusion Ultrasound can sensitively detect pathological changes of joint synovium and entheses,reflect the degree of inflammation indirectly,and can be used to follow up AS patients and evaluate clinical efficacy.

关 键 词：脊柱炎 强直性 超声 彩色多普勒 

分 类 号：R593.23[医药卫生—内科学]