彩色多普勒超声在强直性脊柱炎患者骶髂关节炎疗效评估的价值  

Evaluation of therapeutic effects on sacroiliitis in ankylosing spondylitis patients by color ultrasound

作　　者：薛勤[1] 朱家安[2] 汪年松[1] 高许萍[1] 严艳[1] 李军辉[1] 俞岗[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：《中华临床医师杂志（电子版）》2012年第13期121-123,共3页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(81171353);上海市卫生局基金(2009092)

摘　　要：目的探讨彩色多普勒超声在强直性脊柱炎(AS)患者骶髂关节炎疗效评估中的价值。方法对比30例健康志愿者和50例AS患者骶髂关节的彩色多普勒高频声像和血流情况及AS患者用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白质注射剂治疗前、后骶髂关节高频声像和血流的改变,并将治疗前后的血沉、C反应蛋白和毕氏AS活动指数(BASDAI)、功能指数(BASFI)等作对比分析。结果与健康志愿者比较AS患者骶髂关节超声检查阳性率差异有显著性意义(P<0.05);治疗前骶髂关节血流阻力指数为0.57±0.09;治疗12周和24周后超声检查阳性率均较治疗前有明显下降(P<0.05);治疗后12周及24周骶髂关节血流阻力指数分别为0.65±0.08、0.63±0.05,与治疗前比较差异有统计学意义(P<0.05)。治疗前、治疗后12周和24周比较,患者BASDAI、BASFI、血沉、C反应蛋白差异均有显著性(P<0.05)。结论彩色多普勒超声能敏感地发现骶髂关节病变的变化情况,可作为这些软组织病变的常规监测手段,并可用于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 therapeutic effects on sacroiliitis in ankylosing spondylitis （AS） patients. Methods Color Doppler high-frequency ultrasound images and blood flow in 30 healthy volunteers and 50 AS patients, changes of high-frequency ultrasound images and blood flow of the involved sites in AS patients pre-and after-Etanercept treatments, as well as erythrocyte sedimentation rate, C- reactive protein, and the Bath ankylosing spondylitis disease activity indices pre- and after treatments were compared. Results Positive rates of sacroiliac joints were significantly different between healthy volunteers and AS patients by ultrasonograph（P 〈 0. 05）. Resistance index in AS patients＇sacroiliac joints was 0. 57 ± 0. 09 before treatment. Positive rates by ultrasonograph were significantly decreased at both 12 weeks and 24 weeks after treatment compared to that before treatment（ P 〈 0. 05）. Resistance index in AS patients＇ sacroiliac joints were 0. 65 ± 0. 08 and 0. 63 ± 0. 05 after treatment 12,24 weeks of Etanercept treatment; there was significant difference for patient＇s BASDAI, BASFI,erythrocyte sedimentation rate, and C-reactive protein before treatment and 12 weeks and 24 weeks after treatment（P 〈 0. 05 ）. Conclusions Ultrasound can sensitively detect pathological changes of joint synovium, thus it may be used as routine methods for monitoring diseases, and used to follow up AS patients and evaluate clinical efficacy.

关 键 词：超声检查 多普勒 彩色 脊柱炎 强直性 骶髂关节 治疗结果 

分 类 号：R445.1[医药卫生—影像医学与核医学]