超声对早期类风湿关节炎手部关节肌腱病变的研究  

Application of Ultrasound Detected Tendon Lesions in Finger and Wrist Joints of Patients with Early Rheumatoid Arthitis

作　　者：宗绍云[1] 陈洋[1] 李芹[2] 马惠[1] 和芳[2] 

机构地区：[1]云南省第一人民医院超声科,昆明市650018 [2]云南省第一人民医院风湿免疫科,昆明市650018

出　　处：《中国超声医学杂志》2013年第11期1017-1020,共4页Chinese Journal of Ultrasound in Medicine

基　　金：云南省科技厅联合专项资金资助(No.2010CD194)

摘　　要：目的探讨超声检查早期类风湿性关节炎(RA)手关节肌腱病变的价值。方法早期RA患者53例、骨关节炎(OA)患者30例、健康志愿者30例,分别利用高频超声观察双腕及指关节肌腱,并观察RA活动期与非活动期时的肌腱病变。结果 RA组双手10指伸指肌腱、屈指肌腱及尺侧腕伸肌腱厚度与OA组及健康对照组比较有统计学差异(P均<0.05)。RA组明显增厚。RA组腱鞘积液检出39例共231个关节、肌腱血流信号检出19例共90个关节、腱鞘囊肿检出3例、肌腱粘连检出32例共190个关节。OA组腱鞘积液检出21例共114个关节、肌腱血流信号检出5例共20个关节、腱鞘囊肿检出9例、肌腱粘连未检出。两组均未见肌腱撕裂。RA活动期与非活动期相比较,在腱鞘积液及肌腱血流信号检出数方面差异有统计学意义(P均<0.05),活动期多见;在肌腱粘连及肌腱厚度方面两组间比较差异无统计学意义(P均>0.05)。结论超声检查可发现早期类风湿关节炎患者肌腱病变;活动期时肌腱病变更多见,在早期诊断中有一定应用价值。Objective To explore the application value of ultrasound in tendon lesions in hand joints of patients with early rheumatoid arthritis（RA）. Methods Double wrists,the first to the fifth Metacarpal phalangeal joint （MCP） and Proximal interphalangeal joint （PIP） of 53 RA patients and 30 OA patients and 30 controls matched of age, gender were examined by high-frequency ultrasonograph, observe changes of tendon lesions in disease active phase and the nonmobile phase. Results The average thickness of extensor tendon and flexor tendon and Ulnar side of wrist exten- sor tendon sheath of the early RA patients was greater than tht OA patients and the controls （P〈0.05）, RA patients with obvious thickening. In RA group,Peritendineum effusion is detected a total of 231 joints, tendon blood flow sig- nals is detected a total of 90 joints,the tendon sheath cyst was detected 3 cases, tendon adhesion is detected a total of 190 joints, in QA group,Peritendineum effusion is detected a total of 114 joints, tendon blood flow signals is detected a total of 20 joints,the tendon sheath cyst was detected 9 cases, tendon adhesion is not found, tendon tear. is not found in two groups, in detecting tendon thickness and tendon blood flow signals in disease active phase and the non- mobile phase. Tendon effusion and tendon blood flow signals present most frequently in disease active phase. There were of no significant difference statistically（P〉0.05） in detecting tendon thickness and tendon adhesions between the two groups. Conclusions High-frequency ultrasonography can detect tendon changes in the early stage of RA, Espe-cially presenting most frequently in disease active phase. It have certain application value in early diagnosis.

关 键 词：超声类风湿关节炎手关节肌腱 

分 类 号：R593.22[医药卫生—内科学]