类风湿性关节炎滑膜病变高频超声表现与Anti-ccp、ESR及CRP的相关性  

Correlation of high-frequency ultrasound manifestations of synovial lesions in rheumatoid arthritis with Anti-CCP,ESR and CRP

作　　者：陈焕[1] 金丹 高姗[1] CHEN Huan;JIN Dan;GAO Shan(Department of Physical Diagnosis,Daqing Longnan Hospital,Daqing,Heilongjiang,China,163458)

机构地区：[1]大庆龙南医院物理诊断科,黑龙江大庆163458

出　　处：《分子诊断与治疗杂志》2024年第10期1823-1826,1831,共5页Journal of Molecular Diagnostics and Therapy

基　　金：黑龙江省卫生健康委员会科研计划项目(20210606031057)。

摘　　要：目的分析类风湿性关节炎(RA)滑膜病变高频超声表现与抗环瓜氨酸肽抗体(Anti-CCP)、红细胞沉降率(ESR)和C反应蛋白(CRP)的相关性,以期为该疾病早期诊断及治疗方案的制定提供更为准确和科学的依据。方法选取2020年1月至2023年3月于大庆龙南医院风湿免疫科住院的治疗前RA患者65例(RA组),另选取同期于本院体检中心行体检的健康者55名(对照组)。比较两组高频超声表现、髌上囊液体厚度、滑膜厚度、滑膜动脉RI及实验室指标(Anti-ccp、ESR及CRP水平),RA组根据Anti-ccp、ESR及CRP阳性标准分为阳性、阴性组,比较Anti-ccp、ESR及CRP阳性及阴性组的髌上囊液体厚度、滑膜厚度、滑膜动脉RI。采用Pearson分析滑膜病变高频超声表现各指标与Anti-ccp、ESR及CRP的相关性。结果对照组膝积液少<4 mm;RA组80%膝积液>4 mm,多对称,尤见于内外侧隐窝。对照组滑膜难辨,RA组滑膜增厚、低回声、分界清、表面糙、见绒毛。彩超示RA组81.53%膝滑膜有明显血流信号,多为Ⅱ、Ⅲ级。RA组髌上囊液体厚度、滑膜厚度、Anti-ccp、ESR及CRP水平均高于对照组,滑膜动脉RI则低于对照组,差异有统计学意义(P<0.05);Anti-ccp、ESR及CRP阳性组髌上囊液体厚度、滑膜厚度水平均显著高于阴性组,滑膜动脉RI低于阴性组,差异有统计学意义(P<0.05)。髌上囊液体厚度、滑膜厚度与Anti-ccp、ESR及CRP水平均呈正相关(P<0.05);滑膜动脉RI与Anti-ccp、ESR及CRP水平均呈负相关(P<0.05)。结论高频超声可清晰观察RA患者的滑膜病变情况,且与Anti-ccp、ESR及CRP等实验室指标存在显著关联性,可为临床诊断RA滑膜病变患者提供有力的参考依据,利于制定更具针对性的治疗措施。Objective To analyze the correlation between high-frequency ultrasound manifestations of synovial lesions in rheumatoid arthritis(RA)and anti-cyclic citrullinated peptide antibody(Anti-CCP),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP),to provide a more accurate and scientific basis for the early diagnosis and treatment of the disease.Methods From January 2020 to March 2023,65 patients with RA before treatment(RA group)were selected from the Department of Rheumatology and Immunology,Daqing Longnan Hospital,and 55 healthy subjects(control group)who underwent physical examination in the physical examination center of our hospital during the same period were selected.The high-frequency ultrasound findings,suprapatellar bursa fluid thickness,synovial thickness,synovial artery RI and laboratory indicators(Anti-CCP,ESR and CRP levels)were compared between the two groups.The RA group was divided into a positive and a negative group based on the positive criteria of Anti-CCP,ESR and CRP.The suprapatellar bursa fluid thickness,synovial thickness and synovial artery RI were compared between the Anti-ccp,ESR and CRP positive and negative groups.Pearson was used to analyze the correlation between high-frequency ultrasound manifestations of synovial lesions and Anti-CCP,ESR and CRP.Results In the control group,the knee effusion was 4 mm less and more symmetrical,especially in the inner and outer recesses.The synovium of the control group was difficult to distinguish,while the synovium of the RA group was thickened,low echo,had a clear boundary,rough surface,and villi.Color Doppler ultrasound showed that 81.53%of the knee synovium in the RA group had obvious blood flow signals,mostly gradeⅡandⅢ.The thickness of the suprapatellar bursa fluid,synovial thickness,Anti-CCP,ESR and CRP levels in the RA group were higher than those in the control group.Additionally,the synovial artery RI was lower than that in the control group,and these differences were statistically significant(P<0.05).The levels of suprapatell

关 键 词：类风湿性关节炎 滑膜病变 高频超声 ANTI-CCP ESR CRP 

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