高频超声在类风湿关节炎患者神经卡压诊断中的应用价值  

Value of High-frequency Ultrasound in the Diagnosis of Peripheral Nerve Compression in Rheumatoid Arthritis Patients

作　　者：高培森[1] 任水明[2] 刘磊[1] 杜智慧[1] 王淑敏[1] GAO Pei-sen REN Shui-ming LIU Lei DU Zhi-hui WANG Shu-min(Department of Ultrasound,2Department of Rheumatology, Ordos Hospital, Ordos, Inner Mongolia 017010, China)

机构地区：[1]内蒙古鄂尔多斯市中心医院超声科,内蒙古鄂尔多斯017010 [2]内蒙古鄂尔多斯市中心医院风湿免疫科,内蒙古鄂尔多斯017010

出　　处：《中国医学科学院学报》2016年第3期327-330,共4页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金(81260221;81460269)~~

摘　　要：目的评估高频超声在类风湿关节炎(RA)患者神经卡压诊断中的应用价值。方法以80例RA患者(研究组)和60例非RA患者为研究对象,行上肢神经超声检查,统计两组受试者的神经卡压发生率;比较有、无神经卡压症状RA患者在年龄、病程、健康评估问卷残疾指数(HAQ-DI)分值、类风湿活动性等方面的差异。结果 RA组上肢神经卡压发病率明显高于对照组(15.0%比3.3%,P=0.046)。伴有神经卡压RA患者与无神经症状患者相比年龄更大[(60.2±11.4)岁比(49.2±7.9)岁;t=2.343,P=0.039],病程更长[(9.50±5.99)年比(5.88±3.87)年;t=2.639,P=0.023],HAQ-DI指数更高(1.58±0.75比0.85±0.67;t=2.490,P=0.030);两组患者在类风湿活动性指数方面差异没有统计学意义(14.50±11.68比16.62±9.24;t=1.141,P=0.278)。结论外周神经病变是RA的常见关节外表现。当RA患者疑似外周神经病变时,应行高频超声检查。Objective To evaluate the value of high-frequency ultrasound （HFUS） in diagnosing pe- ripheral nerve compression in patients with rheumatoid arthritis （RA） . Methods The upper limb nerves were evaluated by HFUS in 80 RA patients （RA group） and 60 non-RA patients （control group）, then the incidence of peripheral nerve compression was recorded respectively. RA patients with/without neurological symptoms were compared in terms of age, disease course, Health Assessment Questionnaire Disability Index （HAQ-DI） score, and clinical disease activity index （CDAI） . Results The incidence of upper limb nerve compression in RA group was significantly higher than that in control group （ 15.0% vs. 3.3%, P = 0. 046） o The patients with nerve compression was older [ （60.2 ± 11.4） y vs. （49.2 ±7.9） y ; t = 2. 343, P = 0. 039 ] and had longer disease course [ （9.50±5.99） yrs. （5.88±3.87） y; t=2.639, P=0.023] and higher HAQ-DI score （ 1.58 ± 0. 75 vs. 0. 85±0. 67 ; t = 2. 490, P = 0. 030） . These two groups had no statistical differences in CDAI （14.50±11.68 vs. 16.62 ±9.24; t=l. 141, P=0.278） . Conclusions Peripheral neuropathies are common extra-articular manifestations in RA patients. HFUS can be valuable in patients suspected of RA.

关 键 词：类风湿关节炎 神经卡压 超声 上肢 

分 类 号：R445.1[医药卫生—影像医学与核医学] R730.41[医药卫生—诊断学]