超声对强直性脊柱炎肌腱附着点炎的研究及临床意义  

Ultrasonic enthesitis study and clinical significance of tendon of ankylosing spondylitis

作　　者：石颖[1] 王欢[1] 闫成兰[2] 雷成功[1] 王兴华[1] 乔英艳[1] 王芹秀[1] 张玖[1] 

机构地区：[1]山西医科大学第二医院超声科,太原030001 [2]山西医科大学第二医院风湿科,太原030001

出　　处：《中华风湿病学杂志》2013年第5期323-326,共4页Chinese Journal of Rheumatology

摘　　要：目的研究强直性脊柱炎（As）患者肌腱端病变的声像图特点，检测超声对AS的诊断价值。方法通过二维及彩色多普勒超声检测30例AS患者和30名健康志愿者双下肢主要的5个肌腱端（股四头肌肌腱止点、髌韧带起点和止点、跟腱止点、足底筋膜跟骨附着点）和双上肢主要的2个肌腱端（肱二头肌长头腱、冈上肌肌腱），并对肌腱端厚度和异常声像指标进行比较。计量资料采用独立样本成组t检验，计数资料采用矿检验或Fisher’s确切概率法。结果病例组与对照组异常声像指标比较：肌腱增厚（94和20项），滑囊炎（56和2项），钙化（7和1项），骨皮质破坏（34和0项），血流信号（59和14项），病例组的各个异常声像指标的项数均高于对照组，除肌腱端钙化累及的肌腱端项数在2组问的差异无统计学意义（P〉0．05），其余肌腱增厚、滑囊炎、骨皮质破坏、血流信号阳性累及的肌腱端项数在2组间差异均有统计学意义（P均〈0．05）。通过二维及彩色多普勒超声可敏感地探查出AS患者肌腱端的异常，对于AS的诊断和鉴别诊断具有重要价值，而且有助于更全面地了解和掌握AS患者肌腱端的病变。Objective To study the ultrasonographic features of enthesopathy in ankylosing spond- ylitis, the value of ultrasound in diagnosis of ankylosing spondylitis was detected. Methods Color Doppler high-frequency ultrasound was adopted to detect 14 entheses in 30 healthy volunteers and 30 patients with ankylosing spondylitis. The enthetic thicknesses and abnormal ultrasonic manifestations were compared bet- ween the two groups. T test, X2 test and Fisher＇s exact probability method were used. Results Comparison between the case group and control group of abnormal sonographic indexes： tendon thickening （94, 20）, bursitis （56, 2）, calcium （7, 1）, the cortical bone destruction （34, 0）, blow flow （59, 14）. The all abno- rmal items in patients with ankylosing spondylitis were higher than those in the control group. Except intraten- dinous calcifications, the other items of abnormalities in every site being detected were significantly different between the two groups （P〈0.05）. Conclusion Color Doppler high-frequency ultrasound can effectively detect enthesopathies in patients with ankylosing spondylitis and so can assist the diagnoses and differential diagnoses of ankylosing spondylitis. And it might be helpful in understanding and mastering enthesopathy in patients with ankylosing spondylitis.

关 键 词：脊柱炎 强直性 超声检查 多普勒 彩色 风湿性疾病 

分 类 号：R593.23[医药卫生—内科学] R445.1[医药卫生—临床医学]