超微血管成像血流检测在痛风性关节炎的临床应用价值  

The clinical application value of blood flow detection by ultra-microvascular imaging in gouty arthritis

作　　者：卢建明[1] 田锦[1] 孙艳娟[1] 武雅婷 常瑞姣 LU Jianming;TIAN jin;SUN Yanjuan;WU Yating;CHANG Ruijiao(Department of Ultrasound,the General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院超声室,宁夏银川750004

出　　处：《宁夏医学杂志》2025年第2期135-138,共4页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(2023A1112)。

摘　　要：目的探讨超声结合超微血管成像血流检测在痛风性关节炎的临床应用价值。方法收集痛风患者85例,分别进行超声检查,对探测到的痛风石及增生滑膜进行能量多普勒及肌骨超声结合超微血管成像血流检测并将血流行半定量分级(0~3级)。结果不同hs-CRP水平的患者超声检查出滑膜增生、关节积液、双轨征、痛风石、骨侵蚀及聚集体比较差异无统计学意义(P>0.05);血清尿酸增高组与正常组PDI和SMI血流检出率差异无统计学意义(P>0.05);SMI在血流半定量0、1级检出血流相当或低于PDI,血流半定量2级、3级高于PDI,血流检出及分级SMI优于PDI(P<0.05);hs-CRP明显增高组SMI血流高分级较轻度增高组和正常组明显增多(P<0.05);hs-CRP与增生滑膜PDI分级、滑膜增生程度分级的相关性相比,hs-CRP与滑膜增生SMI血流分级相关性最好(r=0.546)。结论SMI在检测痛风患者痛风石与增生滑膜内的血流信号较PDI更为敏感,SMI对痛风性关节炎患者增生滑膜血流检测及血流分级,可以作为评估其活动性的一项指标,hs-CRP与SMI血流对痛风的发作频率有一定的预测作用。Objective To evaluate the clinical application value of ultrasound combined with ultra-microvascular imaging blood flow detection in gouty arthritis.Methods 85 patients with gout were collected and performed Ultrasound examination,and then the detected tophi and hyperplastic synovium were detected by PDI and SMI,and the blood flow was classificated by semi-quantitative grade(0~3 grade).Results There was no significant difference in the ultrasound examination of synovial thickening,joint effusion,double-track sign,tophi,bone erosion and aggregates among patients with different hs-CRP levels(P>0.05).There was no significant difference in blood flow detection rates of PDI and SMI between the group with increased serum uric acid and the normal group(P>0.05).The blood flow detected by SMI was equal to or lower than PDI in blood flow semiquantitative score 0 and 1,and higher than PDI in blood flow semi-quantitative score 2 and 3,and SMI for blood flow detection and classification was better than PDI,and the difference was statistically significant(P<0.05).The higher SMI blood flow grade in hs-CRP group was significantly higher than that in mildly increased group and normal group(P<0.05).Compared with the correlation between hs-CRP and synovial hyperplasia PDI grade and synovial hyperplasia degree grade,the correlation between hs CRP and SMI blood flow grading of synovial hyperplasia was the best(r=0.546).Conclusion SMI is more sensitive than PDI in detecting the blood flow signals in tophi and hyperplastic synovium in gout patients.In addition,SMI can be used as one of the indicators to evaluate the activity of gouty arthritis.The blood flow of hs-CRP and SMI has a certain predictive effect on the frequency of gout attacks.

关 键 词：痛风性关节炎 肌骨超声 能量多普勒 超微血管成像 

分 类 号：R575.5[医药卫生—消化系统]