肌骨超声对类风湿性关节炎与痛风性关节炎骨质侵蚀的临床鉴别价值  

Clinical identification value of musculoskeletal ultrasound in the diagnosis of rheumatoid arthritis and gouty arthritis

作　　者：姚黎丽 徐华军[1] 韩运生[1] 李雄峰[1] 施林枫[1] YAO Lili;XU Huajun;HAN Yunsheng;LI Xiongfeng;SHI Linfeng(Department of Ultrasound,Huzhou Central Hospital of Zhejiang Province,Huzhou 313000,China)

机构地区：[1]浙江省湖州市中心医院超声科,浙江湖州313000

出　　处：《中国现代医生》2018年第30期120-122,126,共4页China Modern Doctor

基　　金：浙江省公共创新平台实验动物科技计划项目(2015C37116);浙江省湖州市科学技术局公益性应用研究项目(2017GYB25)

摘　　要：目的探讨肌骨超声对类风湿性关节炎与痛风性关节炎骨质侵蚀的临床鉴别价值。方法选取并收集35例类风湿性关节炎患者(A组)和35例痛风性跖趾关节炎患者(B组)的临床资料,回顾性分析患者关节的骨质侵蚀声像图特征,包括直接征象(骨侵蚀的边界、外形及血流信号)及间接征象(滑膜增生、痛风石、双轨征及点状高回声)。结果 A组患者边界清晰率低于B组(χ~2=36.7956,P<0.05),外形中的圆形率高于B组(χ~2=19.8252,P<0.05),两组患者血流信号差异无统计学意义(χ~2=1.4286,P>0.05);A组滑膜增生发生率高于B组(χ~2=31.2306,P<0.05),痛风石、双轨征及点状高回声发生率均低于B组(χ~2=32.0833,17.5000,19.0909,P均<0.05)。结论根据骨侵蚀的声像图特征,肌骨超声能够对类风湿性关节炎与痛风性跖趾关节炎进行鉴别。Objective To investigate the clinical identification value of musculoskeletal ultrasound in the diagnosis ofrheumatoid arthritis and gouty arthritis. Methods The clinical data of 35 patients with rheumatoid arthritis（group A） and35 patients with gouty arthritis of arthritis （group B） were selected and collected. The characteristics of bone erosion echography of the joints were analyzed retrospectively including direct signs （the edge of bone erosion, shape and bloodflow signals） and indirect signs（synaptic hyperplasia, tophi, double-track and point-like hyperechoic）. Results The edgeclearing rate of patients in group A was lower than that in group B （χ^2=36.7956, P〈0.05）. The circular rate in the shapewas higher than that in group B （X^2=19.8252, P〈0.05）. There was no statistical difference in blood flow signals betweenthe two groups（χ^2=1.4286, P〉0.05）. The incidence of synovial hyperplasia in group A was higher than that in group B（χ^2=31.2306, P〈0.05）. The incidence of tophi, double-track and point-like hyperechoic in group A were lower thanthose in group B（χ^2=32.0833, 17.5000, 19.0909, all P〈0.05）. Conclusion According to the sonographic features of boneerosion, musculoskeletal ultrasound can identify rheumatoid arthritis and gouty arthritis.

关 键 词：类风湿性关节炎 痛风 跖趾关节炎 肌骨超声 骨侵蚀 

分 类 号：R445.1[医药卫生—影像医学与核医学]