高频肌骨超声对海勤人员高尿酸血症和痛风临床分期诊断的应用价值  

Application value of high-frequency musculoskeletal ultrasound in the clinical staging diagnosis of hyperuricemia and gout in naval personnel

作　　者：刘武岩 刘继良 姜梅 于卫国 王卫红 陈松楠 魏金凤 程颜苓 孙建新 李晓萌 Liu Wuyan;Liu Jiliang;Jiang Mei;Yu Weiguo;Wang Weihong;Chen Songnan;Wei Jinfeng;Cheng Yanling;Sun Jianxin;Li Xiaomeng(Beidaihe Rehabilitation Center of the Joint Logistics Support Force,Qinhuangdao 066100,China;Tianjin Rehabilitation Center of the Joint Logistics Support Force,Tianjin 300074,China)

机构地区：[1]联勤保障部队北戴河康复疗养中心,秦皇岛066100 [2]联勤保障部队天津康复疗养中心,天津300074

出　　处：《中华航海医学与高气压医学杂志》2024年第5期659-663,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高频肌骨超声对高尿酸血症(HUA)和痛风性关节炎(GA)临床分期诊断的应用价值,为准确诊断、防治海勤人员HUA和GA提供借鉴。方法回顾性分析2017年9月至2023年9月入住联勤保障部队北戴河康复疗养中心确诊为HUA 321例海勤人员的临床资料,依据《中国HUA与GA诊疗指南(2019年)》临床分期诊断标准,将321例HUA患者分为无症状HUA期(A组,n=188)、亚临床GA期(B组,n=91)、GA期(C组,n=42)。比较各组海勤人员年龄、血尿酸(SUA)、体重指数(BMI)、腰臀比(WHR)、尿素氮(BUN)、肌酐(SCr)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、收缩压(SBP)、舒张压(DBP)等指标。高频肌骨超声检查各组患者关节和肌腱临床分期特征及结晶体分布位置,分析高频肌骨超声对HUA和GA临床分期诊断的应用价值。结果与A组比较,B、C组患者年龄、高血压病、高脂血症、BMI、WHR、SCr、TG、SUA、LDL-C、DBP比较差异有统计学意义(P<0.05)。与B组比较,C组患者年龄、高血压病、SCr、TG、SUA、LDL-C、DBP比较差异有统计学意义(P<0.05)。受累关节病变最多的为第一跖趾关节(MTP1),受累最少的关节为腕关节。与A组比较,B、C组患者滑膜增生、滑膜囊积液、强回声聚集体、双轨征、骨侵蚀、痛风石等6个特征发生率均明显提高(P<0.01);与B组比较,C组患者双轨征、滑膜增生、滑膜囊积液、骨侵蚀、痛风石等5个特征发生率均明显提高(P<0.01)。结论海勤人员特定的环境因素易导致HUA、GA发生;高频肌骨超声通过检测无症状HUA患者关节和肌腱中的单尿酸钠晶体沉积和GA骨侵蚀特征,对临床分期诊断具有较好的应用价值。Objective To explore the application value of high-frequency musculoskeletal ultrasound in the clinical staging diagnosis of hyperuricemia(HUA)and gouty arthritis(GA),and to provide a point of reference for accurate diagnosis and prevention of HUA and GA in naval personnel.Methods A retrospective analysis was conducted on the clinical data of 321 naval personnel diagnosed with HUA who were admitted to the Beidaihe Rehabilitation Center of the Joint Logistics Support Force from September 2017 to September 2023.According to Chinese Guidelines for Diagnosis of Hyperuricemia and Gout(HUA Clinical Staging Diagnosis Criteria),321 HUA patients were divided into asymptomatic HUA stage(Group A,n=188),subclinical GA stage(Group B,n=91),and GA stage(Group C,n=42).The age,serum uric acid(SUA),body mass index(BMI),waist to hip ratio(WHR),blood urea nitrogen(BUN),serum creatinine(SCr),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),systolic blood pressure(SBP),and diastolic blood pressure(DBP)of naval personnel in each group were compared.High frequency musculoskeletal ultrasound was used to examine the joint and tendon in patients of each group to determine the clinical staging characteristics and locations of HUA and GA,and to analyze the application value of high-frequency musculoskeletal ultrasound in the clinical staging diagnosis of HUA and GA.Results Compared with Group A,there were statistically significant differences(P<0.05)in some indicators such as age,hypertension,hyperlipidemia,BMI,WHR,SCr,TG,SUA,LDL-C,and DBP,in Group B and Group C.Compared with Group B,there were statistically significant differences in age,hypertension,SCr,TG,SUA,LDL-C,and DBP,in Group C(P<0.05).The most affected joint is metatarsophalangeal one(MTP1),and the least affected joint is the wrist joint.Compared with Group A,the incidences of synovial hyperplasia,synovial sac effusion,strong echo aggregates,double track sign,bone erosion,and gout stones in Group B and C

关 键 词：高尿酸血症 痛风 海勤人员 肌骨超声 亚临床痛风 

分 类 号：R835.2[医药卫生—航空、航天与航海医学]