肌骨超声评价类风湿性指关节炎的病理特征研究  

Musculoskeletal Ultrasonography in Evaluating the Pathological Features of Rheumatoid Arthritis

作　　者：马玉娜 肖海萍[2] MA Yu-na;XIAO Hai-ping(Henan Institute of Occupational Disease Prevention,Zhengzhou,Henan,450000,China)

机构地区：[1]河南省职业病防治研究院,河南郑州450000 [2]郑州大学第二附属医院,河南郑州450000

出　　处：《黑龙江医学》2022年第11期1364-1366,共3页Heilongjiang Medical Journal

基　　金：河南省2018年科技发展计划(182102310592)。

摘　　要：目的:分析肌骨超声在评价类风湿性指关节炎中的病理特征中的价值。方法:选取58例疑似类风湿性指关节炎患者,分别行肌骨超声检查和磁共振成像(Magnetic Resonance Imaging,MRI)检查,分析两种方法用于类风湿性关节炎的诊断结果、诊断效能、病理特征的检查结果、疼痛亚组、无痛亚组的肌骨超声检查情况及类风湿性关节炎疾病活动评分(Disease activity score 28,DAS28)、肌骨超声半定量评分情况。结果:对类风湿性关节炎,肌骨超声检查漏诊2例,误诊1例;MRI检查漏诊1例;肌骨超声和MRI诊断效果差异无统计学意义(χ^(2)=0.000、0.000、0.259,P>0.05)。肌骨超声对骨侵蚀、滑膜增生、关节积液等病理特征的检出率和MRI差异无统计学意义(χ^(2)=0.102、0.078、0.050,P>0.05);无痛亚组患者DAS28评分、骨侵蚀、滑膜增生、关节积液、滑膜内动脉阻力指数等肌骨超声半定量评分低于疼痛亚组,差异有统计学意义(t=8.314、2.883、3.592、3.652、10.256,P<0.05)。结论:肌骨超声能够对风湿性指关节炎进行准确判断,且可为病理特征的分析提供参考信息,有助于医师为患者制定科学治疗方案。Objective:To analyze the value of musculoskeletal ultrasonography in evaluating the pathological features of rheu⁃matoid arthritis.Methods:A total of 58 patients with suspected rheumatoid arthritis were selected and underwent musculoskeletal ultrasonography and Magnetic Resonance Imaging(MRI)respectively.The diagnostic results,diagnostic efficacy,pathological fea⁃tures,musculoskeletal ultrasonography,and disease activity score 28(DAS28),musculoskeletal ultrasound semi-quantitative score of pain subgroup and painless subgroup of the two methods for rheumatoid arthritis were analyzed.Results:Musculoskeletal ultra⁃sound examination of rheumatoid arthritis was missed in 2 cases and misdiagnosed in 1 case.MRI examination missed 1 case.There was no statistically significant difference in the diagnostic effects between musculoskeletal ultrasound and MRI(χ^(2)=0.000,0.000,0.259,P>0.05).There was no statistically significant difference in the detection rate of musculoskeletal ultrasound on patho⁃logical features such as bone erosion,synovial hyperplasia and joint effusion and MRI(χ^(2)=0.102,0.078,0.050,P>0.05).The DAS28 score,bone erosion,synovial hyperplasia,joint effusion,internal synovial artery resistance index and other musculoskeletal ultrasound semi-quantitative scores in the painless subgroup were lower than those in the pain subgroup,and the difference was statistically significant(t=8.314,2.883,3.592,3.652,10.256,P<0.05).Conclusion:Musculoskeletal ultrasound can accurately judge rheumatoid arthritis,and can provide reference information for the analysis of pathological features,which is helpful for doc⁃tors to formulate scientific treatment plans for patients.

关 键 词：类风湿性指关节炎 肌骨超声 病理特征 半定量评分 诊断效能 

分 类 号：R593.22[医药卫生—内科学]