肌肉骨骼超声对痛风性关节炎的诊断价值  

Diagnostic value of musculoskeletal ultrasonic examination for gouty arthritis

作　　者：叶泽呈 陈瑞 夏柏 徐韦[1] Ye Zecheng;Chen Rui;Xia Bai;Xu Wei(Department of Ultrasonic Diagnosis,Jiangbei Branch of Zhongda Hospital,Southeast University,Nanjing 210044,China)

机构地区：[1]东南大学附属中大医院江北院区超声诊断科,江苏南京210044

出　　处：《海军医学杂志》2024年第5期511-515,共5页Journal of Navy Medicine

基　　金：江苏省临床医学科技专项(BL2013034)。

摘　　要：目的分析肌肉骨骼超声对痛风性关节炎的诊断价值。方法收集2018年6月至2020年1月于东南大学附属中大医院江北院区就诊的60例痛风性关节炎患者作为观察组,同期收集50例其他类型关节炎患者作为对照组,均采用肌肉骨骼超声进行检查,比较2组患者的关节受累情况和超声表现,并分析肌肉骨骼超声对痛风性关节炎的诊断价值。结果2组患者大、小关节病变分布差异有统计学意义(P<0.05)。观察组痛风石检出率、韧带内高回声点检出率、双轨征检出率、骨化检出率、高回声点检出率高于对照组,观察组骨侵蚀检出率、腱鞘炎检出率低于对照组,差异均有统计学意义(P<0.05)。肌肉骨骼超声诊断痛风性关节炎的灵敏度为87.1%,特异度为90.9%,漏诊率为12.9%,误诊率为9.1%,阳性预测值为92.6%,阴性预测值为84.3%,受试者操作特征曲线下面积为0.890。结论肌肉骨骼超声对痛风性关节炎诊断的特异度较高,诊断价值较高,值得临床推广。Objective To analyze the diagnostic value of musculoskeletal ultrasonic examination for gouty arthritis.Methods Sixty patients with gouty arthritis admitted to Jiangbei Branch of Zhongda Hospital from June 2018 to January 2020 were assigned to observation group,and 50 patients with other types of arthritis were assigned to control group.All of them were examined by musculoskeletal ultrasound.The joint lesions and ultrasonic manifestations were compared between the two groups.The diagnostic value of musculoskeletal ultrasonic examination for gouty arthritis patients was analyzed.Results There was a statistically significant difference in the distribution of large and small joint lesions between the two groups of patients(P<0.05).The detection rates of gouty stone,hyperechoic spot in ligament,double track sign,ossification,and hyperechoic spot in the observation group were higher than those in the control group,while the detection rates of bone erosion and tenosynovitis in the observation group were lower than those in the control group(P<0.05).The sensitivity and specificity of musculoskeletal ultrasound in the diagnosis of gouty joint were 87.1%and 90.9%,respectively.The rates of missed diagnosis and misdiagnosis were 12.9%and 9.1%,respectively.The positive and negative predictive values were 92.6%and 84.3%,respectively.The area under ROC curve was 0.890.Conclusion Musculoskeletal ultrasonic examination has high specificity and diagnostic value for gouty arthritis,and is worthy of clinical application.

关 键 词：痛风性关节炎 肌肉骨骼超声 超声表现 诊断价值 

分 类 号：R589.7[医药卫生—内分泌]