7关节超声评分在中西医治疗类风湿关节炎疗效评估中的应用  

Application of 7-joint ultrasound score in evaluating efficiency of Chinese and western medicine in treatment of rheumatoid arthritis

作　　者：吴娇娇[1] 朱向明[1] 胡怡芳[2] 李艳[2] 

机构地区：[1]皖南医学院弋矶山医院超声医学科,安徽芜湖241000 [2]皖南医学院弋矶山医院中医科,安徽芜湖241000

出　　处：《中国介入影像与治疗学》2017年第9期556-560,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家中医药管理局"十二五"重点学科项目[国中医药人教发(2010)32号];安徽省科技厅科技攻关项目(11010402173)

摘　　要：目的探讨7关节超声评分系统(US7)评估中西医治疗类风湿性关节炎(RA)临床疗效的价值。方法根据治疗方法不同将160例RA患者分为益肾清络活血方(YSQL)治疗组和单纯西医治疗组,分别于治疗前、治疗后3个月及6个月进行灰阶超声(GSUS)、能量多普勒超声(PDUS)检查及7关节超声评分(US7)。7个关节即腕关节,第2、3掌指关节(MCPⅡ/Ⅲ)及近端指间关节(PIPⅡ/Ⅲ),第2、5跖趾关节(MTPⅡ/Ⅴ)。评分项目包括GSUS滑膜炎、PDUS滑膜炎、GSUS肌腱/腱鞘炎、PDUS肌腱/腱鞘炎、骨侵蚀(ES)。同时进行C-反应蛋白(C-RP)及血沉(ESR)检测及28关节疾病活动度(DAS28)评价。结果 YSQL治疗组和单纯西医治疗组RA患者治疗前、治疗后3个月及6个月US7系统中GSUS滑膜炎、PDUS滑膜炎、GSUS肌腱/腱鞘炎、PDUS肌腱/腱鞘炎评分差异均有统计学意义(P均<0.01)。所有患者治疗前后ES差异均无统计学意义(P>0.05)。治疗后US7的指标与DAS28、C-RP、ESR呈不同程度的正相关。结论 US7可为临床评估中西医治疗RA的疗效提供依据。Objective To evaluate the value of the 7-joint ultrasound score （US7） in treatment of rheumatoid arthritis （RA） with Chinese and western medicine. Methods A total of 160 RA patients were divided into 2 groups based on differ- ent methods of treatment, including Yi Shen Qing Luo （YSQL） group and western medicine group. The patients were ex amined by grey scale ultrasound （GSUS） and power Doppler ultrasound （PDUS） with US7 at baseline and after 3 and 6 months later. There were 7 related joints and 5 single factors for scoring in US7 system. The joints included the wrist joints, the second/third metacarpophalangeal joints （MCP Ⅱ/Ⅲ ）, the second/third proximal interphalangeal joints （PIP Ⅱ/Ⅲ ） and the second/fifth metatarsophalangeal joints （MTPⅡ/Ⅴ ）. And the factors included synovitis of GSUS, syno vitis of PDUS, myotenositis/tenosynovitis of GSUS, myotenositis/tenosynovitis of PDUS and bone erosion （ES）. Mean- while, the laboratory index included C-reactive protein （C-RP） and erythrocyte sedimentation rate （ESR） were examined. And the clinical indexes as disease activity score in 28 joints （DAS28） were evaluated. Results The statistical differences of synovitis of GSUS, synovitis of PDUS, myotenositis/tenosynovitis of GSUS and myotenositis/tenosynovitis of PDUS scores in US7 system were found in both 2 groups at baseline, 3 months and 6 months after treatment （all P〈0.01）. There was no statisti cal difference of ES before and after treatment in all cases （P〈0.05）. The factors of US7 were positively correlated with DAS28, ORP and ESR in different extent. Conclusion US7 is a viable tool for examining patients with RA.

关 键 词：7关节超声评分 关节炎 类风湿 治疗结果 

分 类 号：R445.1[医药卫生—影像医学与核医学] R593.22[医药卫生—诊断学]