肌骨超声影像特征联合抗CCP抗体水平检测在类风湿关节炎中的诊断价值  

Diagnostic value of musculoskeletal ultrasound imaging features combined with detection of anti-CCP antibody levels in rheumatoid arthritis

作　　者：叶青[1] 朱从英 王新汝 YE Qing;ZHU Congying;WANG Xinru(Department of Ultrasound,Changzhou Wujin Hospital of Traditional Chinese Medicine,Jiangsu Province,Changzhou213161,China)

机构地区：[1]江苏省常州市武进中医医院超声科,江苏常州213161

出　　处：《中国医药导报》2023年第19期166-169,共4页China Medical Herald

基　　金：江苏省“333高层次人才培养工程”项目(LGY 2018063)。

摘　　要：目的探讨肌骨超声影像特征联合抗环瓜氨酸肽(CCP)抗体水平检测在类风湿关节炎中的诊断价值。方法选择2019年4月至2022年3月江苏省常州市武进中医医院(以下简称“我院”)收治的81例类风湿关节炎患者为研究组,另选择我院同期45名体检健康者为对照组。根据28个关节疾病活动指数评分将研究组分成高度活动组(27例)、中度活动组(33例)及低度活动组(21例)。研究组均接受MRI与肌骨超声检查。比较MRI与肌骨超声对3种典型病理特征(骨侵蚀、关节积液、滑膜增生)的检出率;比较两组抗CCP抗体水平;分析肌骨超声影像特征联合抗CCP抗体水平对类风湿关节炎的诊断价值。结果MRI与肌骨超声对骨侵蚀、滑膜增生的检出率比较,差异无统计学意义(P>0.05);肌骨超声对关节积液的检出率高于MRI,差异有统计学意义(P<0.05)。研究组抗CCP抗体水平高于对照组,差异有统计学意义(P<0.05)。高度活动组抗CCP抗体水平高于低度活动组、中度活动组;中度活动组抗CCP抗体水平高于低度活动组,差异有统计学意义(P<0.05)。抗CCP抗体水平与类风湿关节炎患者病情严重程度呈正相关(r=0.573,P<0.01)。关节积液、滑膜增生、抗CCP抗体联合诊断类风湿关节炎的曲线下面积高于各项单独诊断,差异有统计学意义(P<0.05)。结论肌骨超声影像特征(关节积液、滑膜增生)、抗CCP抗体水平在诊断类风湿关节炎中具有重要价值,且三者联合具有更高的诊断价值。Objective To investigate the diagnostic value of musculoskeletal ultrasound imaging features combined with detection of anti-cyclic citrullinated peptide(CCP)antibody levels in rheumatoid arthritis.Methods A total of 81 patients with rheumatoid arthritis admitted to the Changzhou Wujin Hospital of Traditional Chinese Medicine,Jiangsu Province(“our hospital”for short)from April 2019 to March 2022 were selected as the research group,in addition,45 healthy people with physical examination in our hospital during the same time were selected as the control group.According to 28 joint disease activity index scores,the research group was divided into high activity group(27 cases),moderate activity group(33 cases),and low activity group(21 cases).The research group underwent MRI and musculoskeletal ultrasonography.The detection rates of MRI and musculoskeletal ultrasonography for three typical pathological features(bone erosion,joint effusion,and synovial hyperplasia)were compared;the levels of anti-CCP antibodies between two groups were compared;the diagnostic value of musculoskeletal ultrasound imaging features combined with the level of anti-CCP antibody in rheumatoid arthritis was analyzed.Results There was no significant difference in the detection rate of bone erosion and synovial hyperplasia between MRI and musculoskeletal ultrasound(P>0.05);the detection rate of joint effusion of musculoskeletal ultrasound was higher than that of MRI,and the difference was statistically significant(P<0.05).The level of anti-CCP antibody in the research group was higher than that in the control group,and the difference was statistically significant(P<0.05).The level of anti-CCP antibody in high activity group was higher than that in low activity group and moderate activity group,the level of anti-CCP antibody in moderate activity group was higher than that in low activity group,and the differences were statistically significant(P<0.05).The level of anti-CCP antibody was positively correlated with the severity of rheumatoid arth

关 键 词：肌骨超声 影像特征 抗环瓜氨酸肽抗体 类风湿关节炎 诊断价值 

分 类 号：R593.22[医药卫生—内科学]