肌肉骨骼超声检查在痛风性关节炎中的诊断价值  

Diagnostic value of musculoskeletal ultrasonography in gouty arthritis

作　　者：林柳树 刘泽洪[2] LIN Liu-shu;LIU Ze-hong(Department of Ultrasound,Huichang County People′s Hospital of Jiangxi Province,Huichang 342600,China;Department of Medicine,People′s Hospital of Cangzhou City,Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]江西省会昌县人民医院超声科,江西会昌342600 [2]江西省赣州市人民医院内科,江西赣州341000

出　　处：《中国当代医药》2019年第36期155-157,160,共4页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目（GZ2018ZSF690）

摘　　要：目的探讨肌肉骨骼超声检查在痛风性关节炎(GA)中的诊断价值。方法选取2017年4月~2019年6月在我院就诊的82例GA患者作为观察组,选取同期就诊于我院的82例其他类型关节炎患者为对照组。两组均接受肌肉骨骼超声检查。比较两组受累关节情况、超声表现,并分析超声表现诊断GA的敏感度与特异度。结果观察组与对照组关节病变为123、119处,肩关节、腕关节、踝关节、膝关节、近端指间关节、第一跖趾关节受累比例比较,差异无统计学意义(P>0.05);观察组软组织肿胀、骨侵蚀、腱鞘炎比例低于对照组,高回声点、痛风石及高回声点、痛风石、韧带内高回声点或双边征(≥1)比例高于对照组,差异有统计学意义(P<0.05);两组滑膜增生、滑囊骨化、双边征比例比较,差异无统计学意义(P>0.05);韧带内高回声点、平行线、痛风石、高回声点特异度均高于90.00%,而高回声点、痛风石、韧带内高回声点或平行线(≥1)敏感度最高,其次为平行线。结论肌肉骨骼超声检查可显示关节内平行线、痛结石、韧带内和滑膜上高回声点等情况,诊断GA的价值较高,能为临床诊治GA提供参考。Objective To investigate the diagnostic value of musculoskeletal ultrasonography in gouty arthritis(GA).Methods Eighty-two patients with GA who were admitted to our hospital from April 2017 to June 2019 were enrolled in the observation group.Eighty-two patients with other types of arthritis who were treated in our hospital at the same time were selected as the control group.Both groups received musculoskeletal ultrasound.The affected joints,ultrasound findings,and the sensitivity and specificity of the ultrasound findings in the diagnosis of GA were compared between two groups.Results The joint lesions of the observation group and the control group were 123 and 119 respectively.The proportions of the shoulder joint,wrist joint,ankle joint,knee joint,proximal interphalangeal joint and first metatarsophalangeal joint were compared,the difference was not statistically significant(P>0.05).The proportion of soft tissue swelling,bone erosion and tenosynovitis in the observation group was lower than those in the control group,the high echo point,the tophi and the high echo point,the tophi,the high echo point in the ligament or the bilateral sign(≥1)were higher those of the control group,the differences were statistically significant(P<0.05).There was no significant difference between the two groups in synovial hyperplasia,bursal ossification and bilateral sign(P>0.05).Hyperechoic point in ligament,parallel lines and tophi in the ligament,high echo point specificity was higher than 90.00%,while the high echo point,tophi,high echo point or parallel line(≥1)in ligament was the most sensitive,followed by parallel line.Conclusion Musculoskeletal ultrasonography can show the parallel lines in the joints,pain stones,ligaments and high echo points on the synovium.The value of diagnosis of GA is high,which can provide reference for clinical diagnosis and treatment of GA.

关 键 词：痛风性关节炎 肌肉骨骼超声 超声表现 诊断 受累关节 

分 类 号：R589.7[医药卫生—内分泌]