超声与血清学指标评估兔类风湿关节炎的对比分析  

Comparision of ultrasound and serology index in evaluation of rabbits with rheumatoid arthritis

作　　者：陈树强[1] 叶真[1] 郑擎[2] 曾锦树[1] 许翔[1] 刘晖[1] 

机构地区：[1]福建医科大学附属第一医院超声影像科,福建福州350005 [2]福建医科大学附属第一医院风湿血液科,福建福州350005

出　　处：《中国医学影像技术》2016年第8期1160-1164,共5页Chinese Journal of Medical Imaging Technology

基　　金：福建医科大学附属第一医院中青年骨干教师基金(JGG201307)

摘　　要：目的 探讨超声与血清学指标评估兔类风湿关节炎（RA）的应用价值。方法 将雄性新西兰大白兔30只随机分为模型组（25只）和对照组（5只）。对模型组采用卵蛋白诱导法,建立兔RA模型,对照组注射生理盐水。进行超声检查及血清C-反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）及白介素-1（IL-1）检测。对滑膜血流信号、滑膜厚度进行分级,对滑膜炎症的严重程度进行病理评分,并进行统计分析。结果 模型组中23只兔完成实验,共46个关节。模型组于2-3周发生关节腔积液及滑膜增生,随后增生加剧,第8周达到高峰并进入平台期;对照组均无滑膜增生。模型组46个关节中,血流为0级1个,Ⅰ级4个,Ⅱ级22个,Ⅲ级19个;对照组滑膜血流均为0级。模型组TNF-α、CRP、IL-1自第5周起开始缓慢上升,至第8周到达高峰期,并保持相对稳定;对照组TNF-α、CRP、IL-1均呈现稳定低水平。模型组轻、重度滑膜炎的滑膜厚度和血流分级差异均有统计学意义（P均〈0.05）。滑膜厚度与病理评分呈正相关（r=0.798,P〈0.05）,血流分级与病理评分呈正相关（r=0.557,P〈0.05）,TNF-α、IL-1、CRP与滑膜病理评分均呈正相关（r=0.450、0.503、0.529,P〈0.05）。结论 超声可较血清学指标更早、更准确诊断关节滑膜炎病变。Objective To investigate the application value of ultrasound and serological markers in evaluation of rhemeu- told arthrosis （RA） based on rabbit models. Methods Thirty male New Zealand white rabbits were randomized devided in- to model group （n=25） and control group （n= 5）. Ovalbumin inducing method was used to establish rabbit RA model, and saline was injected in control group. Ultrasonic examination and C-reactive protein （CRP）, tumor necrosis factor-alpha （TNF-α）, interleukin-1 （IL-1） detection were carried out. Synovium thickness and blood flow signal were measured and classified respectively. Synovium inflammation pathological score was performed, and statistical analysis was done. Results The experiment were completed successfully in a total of 23 rabbits （46 joints） in model group. In model group, arthroe- dema and synovium hyperplasia were started in the 2nd-3rd week. It reached the peak in about 8th week and enter into plateau peroid. Synovium hyperplasia were nor fount in control group. For the degree of blood flow, there were 1 joint of grade 0, 4 joints of grade Ⅰ , 22 joints of grade Ⅱ , 19 joints of grade HI in model group. Synovium blood flow in control group were grade 0 in all rabbits. The level of TNF-a, CRP and IL-1 started to rise slowly since 5th week, and reached the peak from the 8th week and keep relatively stable. TNF-α, CRP and IL-1 level in control group remained low all the time. The difference of synovium thickness and blood flow grade had statistical significance in mild and serious arthromeningitis （both P〈0.05）. Synovium thickness and pathological score had correlation （r=0. 798, P〈0.05）, and blood flow grade and pathological score had correlation （r=0. 557, P〈0.05）, TNF-α, IL 1, CRP level and pathological score had moderate correlation （r=0. 450, 0. 503, 0. 529, all P〈0.05）. Conclusion Ultrasound can diagnose joint arthromeningitis more ac- curately and earlier than serological markers.

关 键 词：关节炎 类风湿 超声检查 血清学 

分 类 号：R-332[医药卫生] R445.1