肌骨超声对类风湿关节炎患者病情活动性评估的临床价值  

Clinical value of musculoskeletal ultrasound in evaluating disease activity in patients with rheumatoid arthritis

作　　者：郭莉莉 王文平[1] 郝玲丽 李霞 GUO Li-li;WANG Wen-ping;HAO Ling-li(Ultrasonic Diagnosis Department,Nanjing Jiangning Hospital,Nanjing 211112,China)

机构地区：[1]南京市江宁医院超声诊断科,江苏南京211112 [2]南京医科大学第一附属医院儿科,江苏南京210005

出　　处：《中国实验诊断学》2021年第2期217-220,共4页Chinese Journal of Laboratory Diagnosis

基　　金：江苏省自然科学基金(BK20161010)。

摘　　要：目的探讨肌骨超声(MSUS)对类风湿关节炎(RA)患者病情活动性评估的临床价值。方法选取2017年3月-2019年12月期间南京市江宁医院收治的RA患者92例为研究对象,根据疾病活动性评分28(DAS28)将患者分为4组,分别是高活动期组(DAS28>5.1分,n=18)、中活动期组(3.2<DAS28≤5.1分,n=30)、低活动期组(2.6<DAS28≤3.2分,n=25)和缓解期组(DAS28≤2.6,n=19)。比较各组DAS28评分、类风湿因子(RF)、红细胞沉降率(ESR)、C反应蛋白(CRP)水平及MSUS半定量评分,分析MSUS半定量评分与DAS28评分、RF、ESR、CRP间关系,MSUS半定量评分评估RA病情活动性的价值。结果与缓解期组相比,高活动期组、中活动期组及低活动期组DAS28评分及血清RF、ESR、CRP水平、MSUS半定量总评分均较高,差异有统计学意义(P<0.05);MSUS总评分与DAS28评分呈正相关(r=0.572,P<0.05),与血清RF、ESR、CRP水平呈正相关(r=0.547,r=0.581,r=0.508,P<0.05);MSUS半定量总评分临界值为4分时,评估RA病情活动性灵敏度为0.822,特异度为0.895,曲线下面积为0.911(95%CI:0.853-0.969),具有较高评估价值。结论MSUS半定量总评分与RA病情活动性密切相关,对RA病情活动性评估价值较高。Objective To explore the clinical value of muscle bone ultrasound(MSUS)in the evaluation of disease activity in patients with rheumatoid arthritis(RA).Methods 92 patients with RA treated in Nanjing Jiangning hospital from March 2017 to December 2019 were selected as subjects.According to the disease activity score 28(DAS28),the patients were divided into four groups:high activity group(DAS28>5.1,n=18),middle activity group(3.2<DAS≤5.1,n=30),low activity group(2.6<DAS28≤3.2,n=25)and remission group(DAS28≤2.6,n=25).DAS28,rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)level and MSUS semi-quantitative score were compared in each group.The relationship between MSUS semi-quantitative score and DAS28 score,RF,ESR,CRP was analyzed,and the value of MSUS semi-quantitative score in evaluating RA disease activity was analyzed.Results Compared with the remission group,the DAS28 score and the serum levels of RF,ESR,CRP and the semiquantitative total score of MSUS in the high active group,middle active group and low active group were significantly higher than those in the remission group(P<0.05).The total score of MSUS was positively correlated with the score of DAS28(r=0.572,P<0.05),and positively correlated with the levels of serum RF,ESR and CRP(r=0.547,r=0.581,r=0.508,P<0.05).When the semi-quantitative total score of MSUS was 4,the sensitivity of evaluating RA disease activity was 0.822,the specificity was 0.895,and the area under the curve was 0.911(95%CI:0.853-0.969),which has high evaluation value.Conclusion The semi-quantitative total score of MSUS is closely related to the disease activity of RA,and it is of high value in evaluating the disease activity of RA.

关 键 词：肌骨超声 半定量评分 类风湿关节炎 活动性 

分 类 号：R593.22[医药卫生—内科学]