超声滑膜炎评分对早期类风湿性关节炎短期复发风险的预测价值研究  

Value of ultrasound synovitis score in predicting relapse of rheumatoid arthritis patients with clinical remission

作　　者：侯春杰[1] 汤靖岚[1] 何跟山[1] 何洪峰[1] 胡巧洪[1] 刘莹 张帆[1] 范小明[1] HOU Chunjie;TANG Jinglan;HE Genshan(Department of Ultrasonography,Zhejiang Provincial People's Hospital,People's Hospital of Hangzhou Medical College,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院)超声科,杭州310014

出　　处：《浙江医学》2018年第23期2525-2528,共4页Zhejiang Medical Journal

基　　金：浙江省科技厅公益项目(2017C33097);浙江省卫计委一般项目A类(2015KYA022);浙江省卫计委一般项目B类(2016KYB019)

摘　　要：目的探讨7关节超声评分法(7-joints ultrasound score,US7)中的滑膜炎评分对早期类风湿性关节炎(rheumatoid arthritis,RA)患者临床缓解后短期复发风险的预测价值。方法选择早期RA患者132例,均在进行抗风湿药物治疗后达到临床缓解,即疾病活动性评分(disease activity score in 28 joints,DAS28)<2.6,并连续维持≥6个月。根据12个月随访期内是否复发分为复发组和未复发组。比较两组随访基线时的US7滑膜炎评分差异,并应用ROC曲线评估US7滑膜炎评分对RA患者临床缓解后短期复发风险的预测效能。结果复发组与未复发组的能量多普勒(PD)滑膜炎关节数、PD评分以及滑膜炎总评分差异均有统计学意义(P<0.01或0.05),其中PD评分的AUC最大(0.772)。以PD评分≥1作为是否复发的预测临界值,灵敏度62.9%,特异度80.4%。结论 US7滑膜炎评分法,尤其是PD评分对RA临床缓解后短期复发具有良好的预测效能。Objective To evaluate the value of ultrasound synovitis score in predicting relapse of rheumatoid arthritis(RA)patients with clinical remission. Methods One hundred and thirty two RA patients with a disease activity DAS28 score≤2.6 at least 6 months were followed for 12 months, and the relapse was defined as DAS>2.6 at the follow-up visit. The US7 synovitis scores were recorded and compared between the relapse patients and non-relapse patients. Results There were significant differences in power Doppler(PD) joint counts,PD scores and synovitis total scores (2 vs 0, 2 vs 0, 6 vs 4; all P<0.05) between relapse and non-relapse groups. The area under ROC curve(AUC) of PD scores was 0.772; when set PD scores≥1 as a cut-off point, the sensitivity and specificity in predicting relapse were 62.9% and 80.4%, respectively. Conclusion Ultrasound synovitis scores, especially PD scores may predict relapse of RA patients in clinical remission.

关 键 词：类风湿性关节炎 滑膜炎 复发 预测 

分 类 号：R593.22[医药卫生—内科学]