肌骨超声评价类风湿性关节炎病理特征及炎性病变的临床意义  

The clinical significance of musculoskeletal ultrasound for the evaluation of the pathological features and inflammatory lesions of rheumatoid arthritis

作　　者：许建辉 蓝思荣[1] 程晓雪[1] 李雄 Xu Jianhui;Lan Sirong;Cheng Xiaoxue(Meizhou People's Hospital,Meizhou 514031)

机构地区：[1]广东省梅州市人民医院

出　　处：《中国现代医药杂志》2019年第11期34-36,共3页Modern Medicine Journal of China

摘　　要：目的研究肌骨超声评价类风湿性关节炎病理特征及炎性病变的临床意义。方法采用随机数字法将120例类风湿性关节炎(RA)患者分为对照组(60例)和观察组(60例)。对照组行X光检查,观察组行肌骨超声检查,比较两种方法的检出效果。结果观察组的滑膜增生、关节积液检出率远大于对照组(P<0.05),但两种检查方法对患者骨侵蚀情况的检出率差异无统计学意义(P>0.05);Pearson直线相关分析显示,滑膜厚度分级和滑膜血流信号分级与超敏C-反应蛋白、红细胞沉降率、类风湿因子、抗环状瓜氨酸多肽抗体均有一定的相关性,其中滑膜血流信号与以上血清学指标的相关性更显著(P<0.01);活动期滑膜内动脉阻力值(0.66±0.14)明显低于非活动期(0.82±0.18)(P=0.00)。结论肌骨超声评价类风湿性关节炎与X光检查相比具有更高的检出率,并且检查结果与超敏C-反应蛋白、红细胞沉降率、类风湿因子值呈正相关,此外对活动期和非活动期RA的鉴别有积极意义,可为RA患者的诊断和治疗以及预后判断提供指导依据。Objective To study the clinical significance of musculoskeletal ultrasound for the evaluation of the pathological features and inflammatory lesions of rheumatoid arthritis.Methods 120 patients with rheumatoid arthritis(RA)were divided into control group and observation group by random number method,with 60 patients in each group.Patients in the control group received X-ray examination and patients in the observation group received musculoskeletal ultrasound examination.Compared the detection effect of the two methods.Results The detection rate of synovial hyperplasia and joint effusion in the observation group was significantly higher than that in the control group(P<0.05),but there was no significant difference between the two methods in the detection rate of bone erosion in patients(P>0.05).Pearson linear correlation analysis showed that synovial thickness grading and synovial blood flow signal grading had certain correlations with hypersensitive C-reactive protein,erythrocyte sedimentation rate,Anti-ccp and rheumatoid factor and the above serological indicators was more significant(P<0.01).The resistance value of intrasynovial artery in the active phase(0.66±0.14)was significantly lower than that in the inactive phase(0.82±0.18)(P=0.00).Conclusion Musculoskeletal ultrasound has a higher detection rate of rheumatoid arthritis than X-ray examination,and the result is positively correlated with hypersensitive C-reactive protein,erythrocyte sedimentation rate and rheumatoid factor.It can provide guidance for the diagnosis,treatment and prognosis of patients with RA.

关 键 词：肌骨超声 X光检查 风湿性关节炎 病理特征 炎性病变 

分 类 号：R59[医药卫生—内科学]