肌骨超声在类风湿关节炎和痛风性关节炎患者有症状关节病变诊断中的作用比较  

A comparative evaluation of the role of musculoskeletal ultrasound in diagnosing symptomatic joint lesions in patients with rheumatoid arthritis and gouty arthritis

作　　者：王佩瑶 徐胜前[2] 何丹青[1] 岑阳 秦杨阳 李军[1] 邵丽萍 黄猛[1,3] Wang Peiyao;Xu Shengqian;He Danqing;Cen Yang;Qin Yangyang;Li Jun;Shao Liping;Huang Meng(Dept of Ultrasound,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;Dept of Rheumatology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;Dept of Ultrasound,East District of First Affiliated Hospital of Anhui Medical University(Feidong People′s Hospital),Hefei 231600)

机构地区：[1]安徽医科大学第一附属医院超声科,合肥230022 [2]安徽医科大学第一附属医院风湿免疫科,合肥230022 [3]安徽医科大学第一附属医院东城院区(肥东县人民医院)超声科,合肥231600

出　　处：《安徽医科大学学报》2024年第5期880-884,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家重点研发计划项目(编号:2022YFC2504603);合肥市卫生健康委应用医学研究项目(编号:Hwk2022zc054)。

摘　　要：目的应用肌骨超声(MSUS)比较类风湿关节炎(RA)和痛风性关节炎(GA)有症状关节病变的超声征象。方法回顾性分析85例RA住院患者和同期55例GA住院患者,比较两组一般资料、病变关节情况及超声征象的差异。结果两组性别、年龄段、病变关节情况比较差异均有统计学意义(均P<0.05);膝关节病变检出率均最高;RA组滑膜炎灵敏度高、半月板损伤特异度高、骨侵蚀诊断效能高,GA组点状强回声、双轨征、痛风石3项联合超声征象诊断效能高于任一项单独诊断且灵敏度和特异度也较高;RA组病程与骨侵蚀呈正相关(P<0.05),GA组病程与痛风石呈正相关(P<0.05)。结论RA与GA的超声征象具有一定差异,MSUS在二者诊断及鉴别诊断上具有较好价值。Objective To compare the ultrasound signs of symptomatic joint lesions in rheumatoid arthritis(RA)and gouty arthritis(GA),musculoskeletal ultrasound(MSUS)was utilized.Methods A retrospective analysis was performed for 85 hospitalized patients with RA and 55 hospitalized patients with GA in the same period,and the differences in general data,diseased joints and ultrasound signs between the two groups were compared.Results The gender,age and diseased joints of the two groups were statistically significant(all P<0.05).The detection rate of knee joint lesions was the highest;the RA group had high sensitivity,high specificity of meniscal injury,and high diagnostic efficiency of bone erosion,while the diagnostic performance of the three combined ultrasound signs of punctate strong echo,double track sign and tophi in the GA group was higher than that of any individual diagnosis,and the sensitivity and specificity were also higher.The course of disease in the RA group was positively correlated with bone erosion(P<0.05),and the course in the GA group was positively correlated with tophi(P<0.05).Conclusion The ultrasound signs of RA and GA are different,and MSUS has good value in the diagnosis and differential diagnosis of the two.

关 键 词：肌骨超声 类风湿关节炎 痛风性关节炎 关节病变 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R593.22[医药卫生—诊断学]