新型超声评分法评估痛风性关节炎的可行性研究  

Diagnostic Value of New Ultrasonic Scoring Method For Gouty Arthritis

作　　者：王飞[1] 郑雅朦 吴言[1] 沈文茜 王爽[1] 田家玮[1] 杜国庆[1] Wang Fei;Zheng Yameng;Wu Yan;Shen Wenqian;Wang Shuang;Tian Jiawei;Du Guoqing(Department of Ultrasound,the Second Affiliated Hospital of Harbin Medical University,Harbin , Heilongjiang 150086 , China)

机构地区：[1]哈尔滨医科大学附属第二医院超声科

出　　处：《中国超声医学杂志》2019年第7期650-652,共3页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金(No.81671762);黑龙江省博士后启动基金(No.LBH-Q16144)

摘　　要：目的探讨新型超声评分法对痛风性关节炎(GA)的评估价值。方法回顾性分析116例关节肿痛患者,对二维及彩色多普勒超声特征进行超声评分,并与血尿酸(UA)及临床评分行相关分析。计算组内相关系数(ICC)评价其重复性。结果患者包括64例GA (124个关节)和52例非GA (104个关节)。与非GA组比较,GA组临床评分明显增高(11.62±3.50vs 4.90±2.66,P<0.001)、血尿酸增高[(471.78±157.64)μmol/L vs (315.69±119.19)μmol/L,P<0.01]、超声评分明显增高(8.58±3.03vs 4.67±2.61,P<0.001);(2)超声评分与临床评分呈正相关(r=0.62,P<0.001),临床评分与血尿酸呈正相关(r=0.595,P<0.001),但超声评分与尿酸无相关性;(3)ROC分析:超声评分诊断GA的曲线下面积为0.84,以5.50分为截断值,诊断GA灵敏度82.00%、特异度68.75%;(4)超声评分法观察者间及观察者内ICC分别为0.96和0.98。结论新型超声评分法对受累关节的半定量评估,为诊断GA提供一种有效的超声方法。Objective To evaluate the diagnostic value of new ultrasonic scoring method for gouty arthritis(GA).Methods A retrospective analysis of 116 patients with joint pain.Based on the two-dimensional ultrasound and color Doppler flow imaging,the ultrasonic score of every joint was calculated.The correlation were analyzed between the ultrasonic score and clinical score,and blood uric acid(UA).The intraclass correlation coefficient(ICC)was calculated to evaluate the reproducibility of the ultrasonic scoring method.Results 116 patients were clinically graded,including 64 patients with GA(124 joints)and 52 patients without GA(104 joints).GA group had a significantly higher clinical score(11.62±3.50 vs 4.90±2.66,P<0.001),UA(471.78±157.64μmol/L vs 315.69±119.19μmol/L,P<0.01),and the ultrasonic score(8.58±3.03 vs 4.67±2.61,P<0.001)than those of the without GA group.There was a significant positive correlation between ultrasonic score and clinical score(r=0.62,P<0.001),and between clinical score and uric acid(r=0.595,P<0.001),but there was no correlation between ultrasonic score and uric acid.ROC showed that the AUC in diagnosing GA by ultrasonic score was 0.84.When the cutoff value was 5.5,the sensitivity and specificity were 82.00% and 68.75%,respectively.The ICC for inter-observer and intra-observer were 0.96 and 0.98,respectively.Conclusions The new ultrasonic scoring method can provide an effective method for clinical diagnosis of GA by semi-quantitative evaluation of the involved joints.

关 键 词：超声评分 痛风性关节炎 

分 类 号：R445.1[医药卫生—影像医学与核医学] R589.7[医药卫生—诊断学]