超声早期诊断无症状高尿酸血症患者关节病变  

Ultrasonography in early diagnosis of joint involvement in patients with asymptomatic hyperuricemia

作　　者：何秀珍 王月香[2] 梁峭嵘[1] 黄春燕[1] 李少君[1] 

机构地区：[1]广州中医药大学附属佛山市中医院超声科,广东佛山528000 [2]中国人民解放军总医院超声科,北京100853

出　　处：《中国介入影像与治疗学》2013年第9期563-565,共3页Chinese Journal of Interventional Imaging and Therapy

基　　金：佛山市科技局医学类科技攻关项目(20120819)

摘　　要：目的探讨高频超声对早期诊断无症状高尿酸血症患者关节病变的价值。方法采用高频超声随机检查75例无症状高尿酸血症患者（无症状组）和100名健康体检者（对照组）的双侧第一跖趾关节、踝关节、膝关节（共1050个关节）。声像图中出现以下征象之一为超声检查阳性：滑膜增厚、关节腔积液、晶体沉积、痛风石、骨侵蚀、滑膜内出现血流信号。结果无症状组关节病变的超声检出率为16．00％（12／75），远高于对照组（0）。无症状组有14个病变关节（14／450），均位于第一跖趾关节。病变关节的超声表现：滑膜增厚8个，关节腔积液3个，晶体沉积5个，骨侵蚀6个；20～60岁不同年龄段无症状高酸尿血症患者均可能出现关节病变。结论无症状高尿酸血症患者可能已出现关节病变。高频超声能早期诊断无症状高尿酸血症患者关节病变，可作为常规影像学筛查手段，应以第一跖趾关节作为检查的重点。Objective To investigate the value of high frequency ultrasonography for early diagnosis of joint involvement in patients with asymptomatic hyperuricemia. Methods Seventy-five patients with asymptomatic hyperuricemia （asymptomatic hyperurice mia group） and 100 healthy volunteers （control group） underwent high frequency ultrasonography. The examined joints included metatarsophalangeal joint, ankle and knee. The presence of one of the following ultrasonographic features was considered positive ultrasonography.. Synovium proliferated, joint fluid, crystals, arthritic calculus, bone erosion, and pannus. Results A total of 1050 joints were examined with ultrasonography. The detection rate of joint involvement in asymptomatic hyperuricemia group （12/75, 16.00 %） was significantly higher than that in control group （0）. The first metatarsophalangeal joint involvement was detected in 14 joints （14/450） in asymptomatic hyperuricemia group, with ultrasonic appearances including synovium proliferated （n = 8）, joint fluid （n = 3）, crystals （n = 5） and bone erosion （n 6）. Joint involvement could occur in patients of different age （20-60 years old）. Conclusion Patients with asymptomatic hyperuricemia might have joint involvement. High frequency ultrasound can be used for early diagnosis of joint involvement in patients with asymptomatic hyperuricemia, and screening should be focused on the first metatarsophalangeal joint.

关 键 词：高尿酸血症 关节炎 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R589.7[医药卫生—诊断学]