类风湿关节炎患者手关节超声表现特点与临床指标的关系  

Ultrasound features of hand and joint in patients with rheumatoid arthritis and its relationship with clinical indicators

作　　者：郇稳[1] 王旭[1] 桂银莉[1] 史丽璞[1] Xun Wen;Wang Xu;Gui Yinli;Shi Lipu(Department of Immune Rheumatism, Zhengzhou People’s Hospital, Zhengzhou 450003, China)

机构地区：[1]郑州人民医院风湿免疫科,450003

出　　处：《中国实用医刊》2019年第1期70-72,共3页Chinese Journal of Practical Medicine

摘　　要：目的研究类风湿关节炎(RA)患者手关节的超声特点与临床指标的关系。方法随机选择郑州人民医院2016年6月至2018年3月收治的RA患者52例为研究对象(观察组),另选取同期52例健康人为对照组。两组均进行超声检查,包括双侧第1~5掌指关节、第2~5近端指间关节和腕关节的滑膜厚度,观察滑膜内的血流供应情况、是否形成血管翳以及关节积液状况等。观察比较两组红细胞沉降率(ESR),C反应蛋白(CRP)、类风湿因子(RF)以及抗环瓜氨酸多肽(CCP)抗体水平。结果观察组双侧第1~5掌指关节、第2~5近端指间关节和腕关节的滑膜厚度大于对照组(P<0.05);观察组血流供应情况(2级22例,3级23例)优于对照组(0级41例,1级11例),且对照组未出现血管翳,观察组45例患者出现血管翳(P<0.05);对照组关节腔内积液无回声区<0.2 cm,观察组关节腔内积液无回声区>0.3 cm,两组比较差异有统计学意义(P<0.05);观察组ESR、CRP、RF和抗CCP抗体水平均高于对照组,差异有统计学意义(P<0.05)。观察组RA患者超声学特点和临床指标有一定的相关性。结论RA患者进行超声检查在临床上具有一定的诊断价值,与RA患者的临床指标有明显的相关性,可以作为评估RA患者病变的主要检查方法之一。Objective To study the relationship of ultrasound features of hand and joint with the clinical indicators in patients with rheumatoid arthritis (RA). Methods Fifty-two RA patients in Zhengzhou People’s Hospital from June 2016 to March 2018 were randomly selected as the experimental subjects, called observation group. At the same time, 52 healthy persons patients were selected as control group in the same period. Patients in the two groups underwent ultrasound examinations to check synovium thickness of bilateral 1-5 metacarpophalangeal joints, 2-5 proximal interphalangeal joints and wrist joints. At the same time, blood supply, formation of vasospasm, joint effusion of joints were observed, too. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), and anti-cyclic citrullinated peptide (anti-CCP) antibodies were detected and compared between the two groups. Results The thicknesses of the synovial membrane of the bilateral 1-5 metacarpophalangeal joints, 2-5 proximal interphalangeal joints and wrist joints of observation group were significantly higher than those of control group (P<0.05). The blood supply of observation group (22 cases of grade 2, 23 cases of grade 3) was significantly superior to that of control group (41 cases of grade 0, 11cases of grade 1), there was no vasospasm in control group, and 45 cases of vasospasm were found in observation group (P<0.05). Echo-free space of joint effusion was <0.2 cm in control group, and it was >0.3 cm in observation group, and the difference was significant between the two groups (P<0.05). The level of ESR, CRP, RF and anti-CCP antibodies of observation group was significantly higher than that of control group (P<0.05), indicated the characteristics of the ultrasound examination in observation group were related to these clinical indicators. Conclusions Ultrasound examination has a certain diagnostic value for RA patients in clinical practice, and it has obvious correlation with the clinical indicators, which can be used as a maj

关 键 词：类风湿关节炎 手关节 超声特点 临床指标 

分 类 号：R593.22[医药卫生—内科学] R445.1[医药卫生—临床医学]