肌骨超声预测甲氨蝶呤治疗类风湿性关节炎的效果  

Study on the Effect of Musculoskeletal Ultrasound in Predicting Methotrexate in th Treatment of Rheumatoid Arthritis

作　　者：程琳 陈斐臻 吴韦贤[1] 宫玉榕[1] CHENG Lin;CHEN Feizhen;WU Weixian;GONG Yurong(Department of Ultrasound Medicine,People's Hospital of Fujian University of Chinese Medicine,Fuzhou 350004,Fujian,China)

机构地区：[1]福建中医药大学附属人民医院超声医学科,福建福州350004

出　　处：《中国药物滥用防治杂志》2024年第12期2218-2219,共2页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：福建省科技厅面上项目(编号:2022J01854)。

摘　　要：目的:探究肌骨超声对类风湿性关节炎患者甲氨蝶呤治疗效果的预测价值分析。方法:于2020年1月—2024年5月期间选取60例类风湿关节炎患者为本研究对象,根据28关节疾病活动性评分(DAS28)将患者分组为低活动组(18例,DAS28评分2.6~3.1分)、中活动组(23例,DAS评分3.2~5.1分)、高活动组(19例,DAS28评分>5.1分),比较三组MSKUS半定量评分;同时根据患者治疗后效果分为两组,比较疗效欠佳、疗效良好患者MSKUS半定量参数评分;另采用ROC曲线分析MSKUS半定量参数评分预测疗效结局效能。结果:RA低活动组滑膜增生、关节积液、骨侵蚀及滑膜内的血流信号评分均低于中活动组与高活动组(P<0.05);临床疗效欠佳组滑膜增生、关节积液、骨侵蚀、滑膜内的血流信号评分均高于临床疗效良好组(P<0.05);经ROC曲线分析显示,滑膜增生、关节积液、骨侵蚀、滑膜内及联合的血流信号预测RA患者疗效的AUC分别为0.730、0.705、0.833、0.724、0.929。结论:MSKUS半定量参数能够预测甲氨蝶呤治疗后类风湿性关节炎患者疗效情况,以期为及时治疗提供重要依据。Objective:To explore the predictive value of musculoskeletal ultrasound in the treatment of methotrexate in patients with rheumatoid arthritis.Methods:From January 2020 to May 2024,60 patients with rheumatoid arthritis were selected as the subjects of this study.According to the 28-joint disease activity score(DAS28),the patients were divided into low activity group(18 patients,DAS28 score 2.6-3.1 scores),moderate activity group(23 patients,DAS score 3.2-5.1 scores),and high activity group(19 patients,DAS28 score>5.1 scores).The MSKUS semi-quantitative scores of the three groups were compared.At the same time,the patients were divided into two groups according to the effect after treatment,and the MSKUS semi-quantitative parameter scores of patients with poor efficacy and good efficacy were compared.In addition,ROC curve was used to analyze the efficacy of MSKUS semi-quantitative parameter score in predicting efficacy outcome.Results:The scores of synovial hyperplasia,joint effusion,bone erosion and blood flow signal in synovial membrane in RA low activity group were lower than those in moderate activity group and high activity group(P<0.05).The scores of synovial hyperplasia,joint effusion,bone erosion and synovial blood flow signal in the poor clinical efficacy group were higher than those in the good clinical efficacy group(P<0.05).ROC curve analysis showed that the AUC of synovial hyperplasia,joint effusion,bone erosion,intrasynovial and combined blood flow signals in predicting the eficacy of RA patients were 0.730,0.705,0.833,0.724 and 0.929,respectively.Conclusion:MSKUS semi-quantitative parameters can predict the efficacy of patients with rheumatoid arthritis after methotrexate treatment,in order to provide an important basis for timely treatment.

关 键 词：肌骨超声 类风湿关节炎 甲氨蝶呤 预测 

分 类 号：R59[医药卫生—内科学]