肌骨超声对痛风性关节炎不同时期病变的应用价值  

The Application Value of Muscle Bone Ultrasound in Different Stages of Gouty Arthritis Lesions

作　　者：臧芳 欧阳卓静 梁宇雄 余健成 冯蓬凤 ZANG Fang;OUYANG Zhuojing;LIANG Yuxiong;YU Jiancheng;FENG Pengfeng(Department of Functional Examination,Kaiping Traditional Chinese Medicine Hospital,Kaiping,Guangdong 529300,China;Department of Nephrology,Kaiping Traditional Chinese Medicine Hospital,Kaiping,Guangdong 529300,China;Department of Internal Medicine,Kaiping Traditional Chinese Medicine Hospital,Kaiping,Guangdong 529300,China)

机构地区：[1]开平市中医院功能检查科,广东开平529300 [2]开平市中医院肾病科,广东开平529300 [3]开平市中医院大内科,广东开平529300

出　　处：《中国医药指南》2025年第2期5-8,共4页Guide of China Medicine

基　　金：2023年度江门市医疗卫生科技计划项目(2023YL10014)。

摘　　要：目的研究肌骨超声对不同时期痛风性关节炎(GA)在下肢关节的特异性表现与非特异性超声表现。方法选取2023年4月至2024年5月来开平市中医院就诊的GA患者伴或不伴无症状高尿酸血症(HUA)患者共192例,其中GA不伴HUA组患者92例,GA伴HUA组100例,将GA伴HUA组又分为首发组(50例)和复发组(50例)。对双下肢的第一跖趾关节(MTP1)、踝关节、膝关节进行超声扫查,分别记录3组双轨征、痛风石、聚集体、滑膜增生、关节积液及骨侵蚀情况。对无症状高尿酸血症患者及GA患者对比分析在不同关节、不同病程的分布情况了解GA的特异性征象和非特异征象。结果GA伴HUA复发组双轨征、痛风石、聚集体、滑膜增生、滑膜层血流低、关节积液、骨破坏等特异性征象阳性率均高于GA伴HUA首发组与GA不伴HUA组(P<0.05)。GA伴HUA复发组双轨征、痛风石、聚集体、滑膜增生、滑膜层血流低、关节积液、骨破坏非特异性征象在MTP1中的发生率均高于膝关节与踝关节(P<0.05)。结论肌骨超声对不同时期GA在下肢关节的特异性表现与非特异性超声表现比较明显,肌骨超声在GA患者中对双轨征的检出率较高。Objective To study the specific and nonspecific ultrasonic manifestations of gouty arthritis(GA)in lower limb joints in different periods by musculoskeletal ultrasound.Methods A total of 192 patients with GA with or without asymptomatic hyperuricemia(HUA)who visited Kaiping Hospital of Traditional Chinese Medicine from April 2023 to May 2024 were selected,including 92 patients with GA without HUA,100 patients with GA with HUA,and the patients with GA with HUA were subdivided into initial group(50 cases)and recurrent group(50 cases).The first metatarsophalangeal joint,ankle joint and knee joint of both lower limbs were scanned by ultrasound,and three groups of double track sign,tophus,aggregate,synovial hyperplasia,joint effusion and bone erosion were recorded respectively.To compare and analyze the distribution of asymptomatic hyperuricemia patients and gouty arthritis patients in different joints and different course of disease to understand the specific signs and nonspecific signs of gouty arthritis.Results The positive rate of specific signs such as double-track sign,tophus,aggregate,synovial hyperplasia,low blood flow in synovial layer,joint effusion and bone destruction in the recurrent group with GA and HUA was higher than that in the initial group with GA and without HUA(P<0.05).The incidence of specific signs such as double-track sign,tophus,aggregate,synovial hyperplasia,low blood flow in synovial layer,joint effusion and bone destruction in the recurrent group of GA with HUA was higher than that in the knee joint and ankle joint(P<0.05).Conclusions The specific and nonspecific manifestations of musculoskeletal ultrasound in different stages of gouty arthritis in lower limbs are more obvious,and the detection rate of musculoskeletal ultrasound in patients with gouty arthritis is high,which is worthy of clinical application.

关 键 词：痛风性关节炎 无症状高尿酸血症 肌骨超声 下肢关节 特异性征象 非特异性征象 

分 类 号：R589.7[医药卫生—内分泌] R684.3[医药卫生—内科学]