肌骨超声半定量分级评价类风湿关节炎患者关节活动性的临床价值  

Clinical value of semi-quantitative grading of musculoskeletal ultrasound in the evaluation of joint activity in patients with rheumatoid arthritis

作　　者：王朝歆[1] 杨玲[1] 李文华[1] 王超[1] 薛晓轩[1] 陆峥[1] 刘艳[1] 苑舒淇 WANG Chaoxin;YANG Ling;LI Wenhua;WANG Chao;XUE Xiaoxuan;LU Zheng;LIU Yan;YUAN Shuqi(Department of Functional Inspection,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing100078,China)

机构地区：[1]北京中医药大学东方医院功能科,北京100078

出　　处：《中国医药导报》2021年第34期148-151,共4页China Medical Herald

基　　金：北京中医药大学教育科学研究课题项目(XJYB 1949);北京中医药大学东方医院“1166”人才培养项目中青年专家(030903010309)。

摘　　要：目的分析肌骨超声半定量分级评价类风湿关节炎(RA)患者关节活动性的临床价值。方法选取2019年1月至2021年7月北京中医药大学东方医院收治的80例RA患者为研究对象,根据疾病活动评分分为缓解期组,低、中、高活动期组。另选我院同期体检80名健康志愿者为对照组。比较各组关节超声检查及血清学指标水平。结果各组滑膜增生、滑膜血流信号、骨侵蚀、关节积液的超声半定量分级评分、总评分及血清红细胞沉降率(ESR)、类风湿因子(RF)、基质金属蛋白酶3(MMP-3)、抗环瓜氨酸抗体(anti-CCP)、抗突变型瓜氨酸波形蛋白抗体(anti-MCV)水平比较,差异有统计学意义(P<0.05)。其中,高活动期组滑膜增生、滑膜血流信号、骨侵蚀、关节积液的超声半定量分级评分和总分高于中活动期组、低活动期组、缓解期组及对照组(P<0.05);中活动期组高于低活动期组、缓解期组及对照组(P<0.05);低活动期组高于缓解期组及对照组(P<0.05);缓解期组高于对照组(P<0.05)。肌骨超声半定量分级总评分与RA患者血清ESR、RF、CRP、anti-CCP、anti-MCV均呈正相关(r=0.651、0.736、0.720、0.711、0.749,P<0.05)。结论肌骨超声半定量分级与RA患者血清指标密切相关,利用肌骨超声半定量分级可为早期评价患者病情进展提供参考。Objective To analyze the clinical value of musculoskeletal ultrasound semi-quantitative grading to evaluate joint mobility in patients with rheumatoid arthritis(RA).Methods A total of 80 RA patients admitted to Dongfang Hospital of Beijing University of Chinese Medicine from January 2019 to July 2021 were selected as the research objects.According to the disease activity score,they were divided into remission group,low,medium,and high activity group.Another 80 healthy volunteers in the same period were selected as the control group.The levels of joint ultrasound and serological indexes in each group were compared.Results Synovial hyperplasia,synovial blood flow signal,bone erosion,and joint effusion ultrasound semi-quantitative grading score,total score,and the levels of serum erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),matrix metalloproteinase 3(MMP-3),anti-cyclic citrulline antibody(anti-CCP),and anti-mutant citrulline vimentin antibody(anti-MCV)in each groups were compared,and the differences were statistically significant(P<0.05).Among them,the ultrasound semi-quantitative grading scores and total scores of synovial hyperplasia,synovial blood flow signals,bone erosion,and joint effusion in the high activity group were higher than those in the medium activity group,low activity group,remission group,and control group(P<0.05);and which in the medium activeity group was higher than those in the low activity group,remission group,and control group(P<0.05);the low activity group was higher than the remission group and the control group(P<0.05);the remission group was higher than the control group(P<0.05).The total score of musculoskeletal ultrasound semi-quantitative classification was positively correlated with serum ESR,RF,CRP,anti-CCP,and anti-MCV in RA patients(r=0.651,0.736,0.720,0.711,0.749,P<0.05).Conclusion The semi-quantitative grading of musculoskeletal ultrasound is closely related to the serum indicators of RA patients.The use of semi-quantitative grading of musculoskeletal ultrasound can

关 键 词：肌骨超声半定量分级 类风湿关节炎 关节活动性 骨代谢 临床价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]