类风湿关节炎超声参数与自身抗体及疾病活动度的关系  

The relationship between musculoskeletal ultrasound synovitis parameters and autoantibody & disease activity in rheumatoid arthritis

作　　者：徐愿[1] 阎小萍[1] 陈璐[1] 张英泽[1] 刘亚绵[1] 卢文昭[1] 陶庆文[1] 

机构地区：[1]中日友好医院中医风湿病科,北京100029

出　　处：《中日友好医院学报》2015年第6期338-341,F0002,共5页Journal of China-Japan Friendship Hospital

基　　金：中日友好医院青年科技英才计划(2015-QNYC-B-08);中日友好医院青年基金课题(2013-QN-03)

摘　　要：目的:研究类风湿关节炎(RA)患者28关节超声参数与自身抗体及疾病活动度的关系。方法:收集77例RA患者,采用灰阶超声(GSUS)和能量多普勒超声(PDUS)对其双侧掌指、近端指间、腕、肘、肩、膝关节共28个关节进行测查,并分级和评分。同时检测患者的自身抗体,包括类风湿因子(RF)、抗CCP抗体(ACPA),疾病活动评估采用28关节疾病活动指数(DAS28)、血沉(ESR)和C反应蛋白(CRP)评估。结果:PDUS评分与ACPA、DAS28、ESR、CRP显著正相关(P<0.01),与RF无相关性。ACPA阴性组与阳性组,以及低滴度组(<200IU/ml)与高滴度组(>200IU/ml)间比较,DAS28阴性与阳性组,以及轻中度活动组与重度活动组间比较,PDUS均有显著差异(P<0.01,P<0.05)。GSUS评分在RF阴性组与阳性组间、以及RF低滴度组与高滴度组间比较,均无显著性差异。结论:RA患者中,关节超声的PDUS参数与疾病活动及ACPA正相关,可能提示疾病活动度与预后。Objective：To study the relationship 5etween 28 joints musculoskeletal ultrasound （US）synovitis amt autoantibody ＆ inflammation in rheumatoid arthritis （RA）.Methods：A total of 77 patients with RA were en- rolled.Twenty-eight joints were examined for every patients by grey-scale ultrasonography （GSUS）and power Doppler uhrasonography（PDUS）.The rheumatoid faetor（RF）,anti-cyclie citrullinated peptides antibody（ACPA）, ESR,CRP were measured.Disease activity score 28 （DAS28）was ealculated.Results：（1）PDUS scores were posi- tively correlated to the levels of ACPA,ESR,CRP and DAS28 （P〈0.01）.There were significantly differences in PDUS scores between ACPA negative and positive group （P〈0.01）and 5etween ACPA lower（〈200IU/ml）and high titer group （〉200IU/ml）（P〈0.01）.In addition,the difference of PDUS were observed between remission group and active group.（2） No association of GSUS scores with RF result was found.Conclusion：PDUS param- eter of musculoskeletal US synovitis might represent the disease activity.

关 键 词：类风湿关节炎 关节超声 能量多普勒 疾病活动度 

分 类 号：R593.22[医药卫生—内科学]