二维超声联合VTIQ定量评估类风湿关节炎正中神经损伤的价值  

Value of two-dimensional ultrasound combined with VTIQ in quantitative evaluation of median nerve injury in rheumatoid arthritis

作　　者：王珊珊[1] 任永凤[1] 王洲[1] 李健[1] 戚建国 WANG Shan-shan;REN Yong-feng;WANG Zhou;LI Jian;QI Jian-guo(Department of Ultrasound,Bozhou People′s Hospital,Bozhou Anhui 236800,China)

机构地区：[1]安徽省亳州市人民医院超声科,236800

出　　处：《蚌埠医学院学报》2023年第11期1569-1572,共4页Journal of Bengbu Medical College

基　　金：安徽医科大学校级科研资助基金项目(2021XKJ218);安徽省亳州市重点研发计划自筹经费项目(bcc201921);安徽省亳州市人民医院院级项目(by2022046)。

摘　　要：目的:探讨二维超声联合声触诊组织成像定量技术(VTIQ)评估类风湿关节炎(RA)正中神经损伤的价值。方法:选择60例RA病人,按照疾病活动度评分(DAS28)分为活动期(活动组)和临床缓解期(缓解组),各30例,另选择同期健康体检者30名为对照组。比较3组腕关节处正中神经前后径、横截面积及剪切波速度差异及与正中神经损伤程度的相关性;通过ROC曲线分析比较各参数的诊断效能;分析RA病人正中神经剪切波速度与DAS28的相关性。结果:3组受试者腕关节处正中神经前后径、横截面积及剪切波速度间差异均有统计学意义(P<0.01),其中活动组前后径、横截面积和剪切波速度均明显大于缓解组和对照组(P<0.01),缓解组横截面积和剪切波速度亦均明显大于对照组(P<0.01)。ROC曲线分析显示,RA病人正中神经前后径、横截面积、剪切波速度对正中神经损伤均有较好诊断价值,其中以剪切波速度诊断效能最高,AUC为0.841,最佳截断值为5.075 m/s;联合诊断以剪切波速度联合横截面积诊断效能较高,AUC为0.883。活动组和缓解组病人正中神经剪切波速度与DAS28均呈明显正相关关系(r_(s)=0.742、0.393,P<0.01)。结论:VTIQ能获取正中神经的弹性信息,可对RA病人正中神经损伤进行定量评估,联合正中神经横截面积诊断价值更高,可为临床诊疗和预后评估提供参考。Objective:To explore the value of two-dimensional ultrasound combined with virtual touch tissue imaging and quantification(VTIQ)in evaluating median nerve injury in rheumatoid arthritis(RA).Methods:Sixty RA patients were selected and divided into active phase(active group)and clinical remission phase(remission group)based on disease activity score(DAS28),with 30 patients in each group,and 30 health examinees during the same period were selected as the control group.The anterior and posterior diameters,cross-sectional areas and shear wave velocities of the median nerve at the wrist joint in the three groups were compared,as well as the correlation with the degree of median nerve injury.The diagnostic efficacy of each indicator was compared through ROC curve analysis.The correlation between shear wave velocity of median nerve and DAS28 was analyzed in RA patients.Results:There were significant differences in the anterior and posterior diameters,cross-sectional areas and shear wave velocities of the median nerve at the wrist joint among the three groups(P<0.01).The anterior and posterior diameters,cross-sectional areas and shear wave velocities in the active group were significantly greater than those in the remission group and control group(P<0.01),and the cross-sectional areas and shear wave velocities in the remission group were also significantly greater than those in the control group(P<0.01).ROC curve analysis showed that the anterior and posterior diameters,cross-sectional areas and shear wave velocities of the median nerve in RA patients had good diagnostic value for median nerve injury.Among them,the diagnostic efficacy of shear wave velocity was the highest,AUC of which was 0.841,and the best cutoff value was 5.075 m/s.The diagnostic efficiency of combined diagnosis of shear wave velocity and cross-sectional area was higher,with an AUC of 0.883.The shear wave velocity of median nerve in active group and remission group was positively correlated with DAS28(r_(s)=0.742,0.393,P<0.01).Conclusions:VTIQ can obta

关 键 词：类风湿性关节炎 声触诊组织成像定量技术 正中神经 

分 类 号：R593.22[医药卫生—内科学] R445.1[医药卫生—临床医学]