van der Heijde 影像学评分在类风湿关节炎量化评定中的应用价值  

The value of imaging van der Heijde score in quantitative assessment for rheumatiod arthritis

作　　者：林志谦[1] 许建荣[1] 刘晓晟[1] 华佳[1] 张科蓓[1] 李磊[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,上海200001

出　　处：《实用放射学杂志》2011年第9期1383-1385,1403,共4页Journal of Practical Radiology

基　　金：上海市重点学科建设项目（S30203）;上海交通大学医学院重点学科建设项目.

摘　　要：目的 探索van der Heijde影像学评分在判断类风湿关节炎（RA）疾病活动度和治疗效果中的应用价值.方法 收集194例经临床证实的RA患者的临床及双手X线正位平片资料,选用DAS28临床评分和van der Heijde评分来对治疗前后的RA病情活动性进行量化评分,并对其进行统计学分析.结果 DAS28评分与van der Heijde评分之间存在显著相 关性（r=0.29,P＜0.000 1）,说明van der Heijde评分高则临床症状严重.治疗前后DAS28评分间有统计学差异（P＜0.05）,说明临床症状改善明显.但治疗前后van der Heijde评分间没有统计学差异（P=0.83）,说明影像学上改善不明显.且患者治疗6月后DAS28评分差值与van der Heijde评分差值间无显著相关性（P=0.38）.结论 van der Heijde评分值与DAS28值密切相关,可以作为判断患者病情严重程度的一个重要参考指标.但van der Heijde评分在判断患者治疗后病情是否好转上存在一定困难.Objective To discuss the value of van der Heijde score in determining the activity and evaluating the therapeutic effect of rheumatoid arthritis（RA）. Methods Clinical and X-ray of hands data in 194 patients with RA were collected in this study. Clinical DAS28 and imaging van der Heijde score were used to evaluate the activity of RA quantitatively before and after treatment. Results There was a linear correlation between DAS28 and vander Heijde score（r= 0.29,P〈0. 0001）. Significant difference of DAS28 value existed before and after treatment（P〈0.05）, but there was no significant difference in van der Heijde score before and after treatment（P=0.83）. And there was no correlation between the differences of DAS28/van der Heijde score before and after treatment（P = 0.38）. Conclusion There is closely correlation between van der Heijde score and DAS28 in quantitative assessment of RA,van der Heijde score can be used as an important index in evaluating the activity of RA.

关 键 词：类风湿关节炎 X线摄影 量化评分 

分 类 号：R593.22[医药卫生—内科学] R814.41[医药卫生—临床医学]