173例关节炎患者新型细针滑膜盲穿活检的滑膜质量和安全性评价  

Evaluation of the Quality and Safety of Synovial Biopsy by New Fine-Needle Synovial Blind Puncture in 173 Patients with Arthritis

作　　者：李建斌 赵俊[1] 龙伟 王燕[1] 谢天 吴锐[1] LI Jian-bin;ZHAO Jun;LONG Wei;WANG Yan;XIE Tian;WU Rui

机构地区：[1]南昌大学第一附属医院,江西南昌330006

出　　处：《风湿病与关节炎》2024年第8期6-10,34,共6页Rheumatism and Arthritis

基　　金：国家自然科学基金项目(82260898)。

摘　　要：目的:探讨新型滑膜活检装置所采集的滑膜质量以及该技术的安全性。方法:回顾性分析2023年1月至2023年12月在南昌大学第一附属医院风湿免疫科采用新型滑膜活检装置行滑膜活检的173例患者临床及滑膜组织信息,包括记录采集的样本组织大小,分析滑膜组织HE染色后滑膜结构完整性,滑膜碎片占比,RNA完整性(RIN)评分等。同时对患者进行问卷调查,内容包括穿刺前后的关节疼痛、僵硬和肿胀,穿刺过程的不适,术后的不良反应、恢复时间等。结果:穿刺部位131例为膝关节,12例为踝关节,23例为腕关节,7例为肘关节。其中25例未见到滑膜组织,取样成功率为85.55%。取样样本平均为10.86 mm^(2)。所有滑膜样本均可见到完整的滑膜结构。可评级的滑膜碎片占比为85.13%,RIN的中位数为7.00。PRO数据显示,在活检前后和活检后1周,VAS评分差异无统计学意义(P>0.05)。未报告严重并发症,包括关节感染、出血或血管迷走神经体征。结论:新型滑膜活检装置可有效进行滑膜取材,且临床安全,患者耐受性良好。Objective:To explore the quality of synovial tissue collected by the new synovial biopsy device and the safety of this technique.Methods:The clinical and synovial tissue information of 173 patients who underwent synovial biopsy using the new synovial biopsy device in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Nanchang University from January 2023 to December 2023 was retrospectively analyzed,including recording the size of the collected sample tissue,analyzing the integrity of the synovial structure after HE staining of the synovial tissue,the proportion of synovial fragments,and RNA integrity(RIN)score,etc.At the same time,patients were surveyed with questionnaires,including joint pain,stiffness and swelling before and after puncture,discomfort during the puncture process,postoperative adverse reactions,recovery time,etc.Results:For the puncture site,the knee joint was in 131 cases,the ankle joint was in 12 cases,the wrist joint was in 23 cases,and the elbow joint was in 7 cases.Among them,synovial tissue was not seen in 25 cases,and the sampling success rate was 85.55%.The average sampling sample was 10.86 mm^(2).Complete synovial structures could be seen in all synovial samples.The proportion of gradable synovial fragments was 85.13%,and the median of RIN was 7.00.PRO data showed that there was no statistically significant difference in VAS score before and after biopsy and one week after biopsy(P>0.05).No serious complications were reported,including joint infection,bleeding or vasovagal signs.Conclusion:The new synovial biopsy device can effectively obtain synovial samples,and is clinically safe with good patient tolerance.

关 键 词：关节炎 滑膜 活检针 滑膜组织 滑膜穿刺活检技术 

分 类 号：R593.2[医药卫生—内科学]