痛风性关节炎肌骨超声表现与血清DKK1、RANKL、尿酸水平的关系  

Musculoskeletal ultrasound findings in patients with gouty arthritis and their correlation with levels of serum DKK1,RANKL and uric acid

作　　者：曾卓华 贺丹 龙滨 吴杨 刘军慧 ZENG Zhuohua;HE Dan;LONG Bin;WU Yang;LIU Junhui(Department of Ultrasound Medicine,the 2nd Affiliated Hospital of Chengdu Medical College·Nuclear Industry 416 Hospital,Chengdu 610051;Department of Oncology,the 2nd Affiliated Hospital of Chengdu Medical College·Nuclear Industry 416 Hospital,Chengdu 610051;Special Ultrasound Department,Air Force Hospital of the Western Theater Command,Chengdu 610021;Department of Urology,the 2nd Affiliated Hospital of Chengdu Medical College·Nuclear Industry 416 Hospital,Chengdu 610051;Department of Hematology and Rheumatology,the 2nd Affiliated Hospital of Chengdu Medical College·Nuclear Industry 416 Hospital,Chengdu 610051)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院超声医学科,成都610051 [2]成都医学院第二附属医院·核工业四一六医院肿瘤科,成都610051 [3]西部战区空军医院超声特诊科,成都610021 [4]成都医学院第二附属医院·核工业四一六医院泌尿外科,成都610051 [5]成都医学院第二附属医院·核工业四一六医院血液风湿科,成都610051

出　　处：《郑州大学学报（医学版）》2022年第1期73-77,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：四川省养老与老年健康中心课题(YLZBZ2024)。

摘　　要：目的:探讨痛风性关节炎肌骨超声表现与血清dickkopf-1(DKK1)、核因子κB受体活化因子配体(RANKL)、尿酸(UA)水平的关系。方法:痛风性关节炎患者125例分为急性组(n=65)和间歇期组(n=60),另选取50例健康人作为对照组。比较急性组和间歇期组肌骨超声表现的差异;检测各组血清DKK1、RANKL、UA水平,分析痛风性关节炎患者肌骨超声特征与血清DKK1、RANKL、UA水平的相关性。采用ROC曲线分析肌骨超声综合评分联合血清DKK1、RANKL、UA水平对痛风性关节炎活动期的诊断效能。结果:间歇期组滑膜炎检出率低于急性组,痛风石、骨侵蚀检出率以及肌骨超声综合评分高于急性组(P<0.05);间歇期组血清DKK1、RANKL、UA水平高于急性组和对照组(P<0.05);痛风性关节炎肌骨超声综合评分与血清DKK1、RANKL、UA水平均呈正相关(r=0.587、0.682、0.418,P<0.001);肌骨超声综合评分联合血清DKK1、RANKL、UA诊断痛风性关节炎活动期的曲线下面积(AUC)为0.911(95%CI:0.856~0.966),敏感度为90.000%,特异度为87.692%。结论:不同时期痛风性关节炎患者肌骨超声表现与血清DKK1、RANKL、UA水平有关,肌骨超声联合血清DKK1、RANKL、UA检测对不同时期痛风性关节炎具有较高的诊断价值。Aim:To analyze the musculoskeletal ultrasound findings in patients with gouty arthritis and their correlation with levels of serum DKK1,receptor activator of nuclear factorκB ligand(RANKL)and uric acid(UA).Methods:Totally 125 patients with gouty arthritis were selected and allocated into acute group(n=65)and intermittent group(n=60),and another 50 healthy people who received physical examination during the same period were selected as control group.The differences in musculoskeletal ultrasound findings were compared between patients with acute gouty arthritis and patients with intermittent gouty arthritis.The levels of serum DKK1,RANKL and UA were detected,and the correlations between musculoskeletal ultrasound characteristics and levels of serum DKK1,RANKL and UA were analyzed in patients with gouty arthritis.Receiver operating characteristic(ROC)curves were drawn to analyze the diagnostic efficacy of musculoskeletal ultrasound comprehensive score combined with levels of serum DKK1,RANKL and UA on active stage of gouty arthritis.Results:The incidence rate of synovitis in intermittent group was significantly lower than that in acute group(P<0.05),while the incidence rates of tophi and bone erosion and ultrasound comprehensive score were significantly higher than those in acute group(P<0.05).The levels of serum DKK1,RANKL and UA of patients in intermittent group were significantly higher than those in acute group and control group(P<0.05).The ultrasound comprehensive score was positively correlated with levels of serum DKK1,RANKL and UA(r=0.587,0.682,0.418,P<0.001).The AUC was 0.911,and 95%CI was 0.856~0.966 for ultrasound comprehensive score combined with serum DKK1,RANKL and UA diagnosing active stage of gouty arthritis.And the sensitivity and specificity were 90.000%and 87.692%.Conclusion:The musculoskeletal ultrasound findings are related to levels of serum DKK1,RANKL and UA.Combined detection of musculoskeletal ultrasound and serum DKK1,RANKL and UA might have high value for diagnosing gouty arthritis at dif

关 键 词：痛风性关节炎 肌骨超声 DICKKOPF-1 核因子ΚB受体活化因子配体 尿酸 

分 类 号：R589.7[医药卫生—内分泌]