足踝部尿酸盐沉积双能CT检出情况与亚临床痛风患者病程及实验室检查指标的关系  

DETECTION OF URATE DEPOSITION IN FOOT AND ANKLE BY DUAL ENERGY CT AND ITS ASSOCIATION WITH THE COURSE OF DISEASE AND LABORATORY MARKERS IN PATIENTS WITH SUBCLINICAL GOUT

作　　者：邵川洋 胡尊英 闵繁懿 李长贵[2] 韩琳[2] 徐文坚[1] SHAO Chuanyang;HU Zunying;MIN Fanyi;LI Changgui;HAN Lin;XU Wenjian(Department of Radiology,The Affiliated Hospital of Qingdao University,Qindao 266003,China)

机构地区：[1]青岛大学附属医院放射科,山东青岛266003 [2]青岛大学附属医院痛风实验室,山东青岛266003

出　　处：《精准医学杂志》2022年第4期351-354,359,共5页Journal of Precision Medicine

摘　　要：目的探究足踝部尿酸盐沉积双能CT(DECT)检出情况与亚临床痛风患者病程及实验室检查指标的关系。方法回顾性分析2019年6月—2021年6月于我院痛风专病门诊就诊的171例无症状高尿酸血症患者的血生化指标、病程及足踝部DECT检查结果,根据DECT是否检出足踝部单钠尿酸盐(MSU)沉积分为阳性组与阴性组。比较足踝部左右侧别、足背足底侧别、胫腓侧别MSU沉积的差异,分析足踝部MSU结晶总体积与患者血生化指标、病程的相关性,并利用Logistic回归分析足踝部MSU沉积的影响因素。结果171例无症状高尿酸血症患者中有113例DECT检出MSU结晶沉积(即亚临床痛风),阳性组患者足背足底侧别、胫腓侧别的MSU结晶沉积情况比较,差异有显著性(χ^(2)=16.449、89.262,P<0.05);阳性组血尿酸(SUA)值、红细胞沉降率(ESR)、肾小球滤过率(GFR)、病程、年龄与阴性组比较差异有显著性(H=-5.289~-2.001,P<0.05);阳性组患者MSU总体积与SUA值、ESR、病程呈正相关(r=0.200~0.292,P<0.05),与GFR呈负相关(r=-0.225,P<0.05)。影响DECT检出足踝部MSU结晶的亚临床痛风患者的因素为SUA值(OR=1.050,95%CI=1.001~1.009,P<0.05),ESR(OR=1.050,95%CI=1.016~1.089,P<0.05),病程(OR=1.016,95%CI=1.007~1.025,P<0.05)。结论SUA值、ESR、GFR及病程与MSU结晶总体积具有相关性,SUA水平升高、ESR升高及病程延长均为亚临床痛风患者足踝部MSU结晶沉积的危险因素,具此类特点患者应及早行影像学筛查以明确诊断。Objective To investigate the detection of urate deposition in feet and ankle by dual-energy CT(DECT)and its association with course of disease and laboratory markers in patients with subclinical gout.Methods A retrospective analysis was performed for the clinical data of 171 patients with asymptomatic hyperuricemia who attended the outpatient service of gout in our hospital from June 2019 to June 2021,including blood biochemical parameters,course of disease,and DECT findings of feet and ankles,and according to whether monosodium urate(MSU)deposition in feet and ankles was detected by DECT,they were divided into positive group and negative group.MSU deposition was compared between the left and right sides of foot and ankle,the dorsal and plantar sides of foot,and the tibial and fibular sides of foot and ankle,and the correlation of the total volume of MSU crystals in foot and ankle with blood biochemical parameters and course of disease was analyzed.The logistic regression analysis was used to analyze the influencing factors for MSU deposition in foot and ankle.Results Among the 171 patients with asymptoma-tic hyperuricemia,113 had MSU crystal deposition(i.e.subclinical gout)detected by DECT,and there was a significant difference in MSU crystal deposition between the dorsal and plantar sides of foot and the tibial and fibular sides of foot and ankle in the positive group(χ^(2)=16.449,89.262,P<0.05).There were significant differences between the positive group and the negative group in serum uric acid(SUA),erythrocyte sedimentation rate(ESR),glomerular filtration rate(GFR),course of disease,and age(H=-5.289--2.001,P<0.05).In the positive group,the total volume of MSU was positively correlated with SUA,ESR,and course of disease(r=0.200-0.292,P<0.05)and was negatively correlated with GFR(r=-0.225,P<0.05).SUA(OR=1.050,95%CI=1.001-1.009,P<0.05),ESR(OR=1.050,95%CI=1.016-1.089,P<0.05),and course of disease(OR=1.016,95%CI=1.007-1.025,P<0.05)were the influencing factors for DECT detection of MSU crystals in foot and ankle

关 键 词：高尿酸血症 无症状疾病 痛风 体层摄影术 X线计算机 结晶 踝 

分 类 号：R445.3[医药卫生—影像医学与核医学] R589.7[医药卫生—诊断学]