原发性痛风性关节炎急性期、间歇期双能量CT和血清ESR、UA差异表达及临床意义  

The difference and significance of dual-energy CT and serum ESR and UA levels in acute and intermittent gouty arthritis

作　　者：张云娜 张伟[1] 胡晰杨[2] 沈苓苓 李民慧 宋莎莎 张健 ZHANG Yunna;ZHANG Wei;HU Xiyang;SHEN Lingling;LI Minhui;SONG Shasha;ZHANG Jian(Department of Medical Imaging,Hebei Province Cangzhou Hospital of Integrated traditional and Western Medicine,Cangzhou 061001;Department of Radiology,Cangzhou Central Hospital,Cangzhou 061001,China)

机构地区：[1]河北省沧州中西医结合医院医学影像科,河北省沧州市061001 [2]河北省沧州市中心医院放射科,河北省沧州市061001

出　　处：《中国煤炭工业医学杂志》2025年第1期56-62,共7页Chinese Journal of Coal Industry Medicine

基　　金：2024年度河北省医学科学研究课题(编号:20240871)。

摘　　要：目的探讨原发性痛风性关节炎(GA)急性期、间歇期双能量CT和血清红细胞沉降率(ESR)、尿酸(UA)表达差异及临床意义。方法选取2021年9月-2023年1月河北省沧州中西医结合医院收治的50例GA急性期患者(急性期组)、50例GA间歇期患者(间歇期组)及50名健康志愿者(对照组)。对比分析3组双能量CT定量结果、定性结果及血清ESR、UA水平,多因素分析GA急性发作的因素,受试者工作特征(ROC)曲线分析双能量CT和血清ESR、UA水平评估GA急性发作的价值。结果急性期组平均总痛风结晶个数、双足痛风结晶体积、双足痛风结晶数量、双手痛风结晶体积、双手痛风结晶数量、关节腔积液患者占比高于间歇期组、对照组(P<0.05);间歇期组平均总痛风结晶个数、双足痛风结晶体积、双足痛风结晶数量、双手痛风结品体积、双手痛风结晶数量、骨质破坏患者占比、关节腔积液患者占比高于对照组(P<0.05);急性期组血清ESR、UA水平>间歇期组>对照组(F=109.203、287.820,P<0.05);平均总痛风结晶个数、双足痛风结晶体积、双足痛风结晶数量、双手痛风结晶体积、双手痛风结晶数量、关节腔积液、血清ESR、UA水平是GA急性发作的相关危险因素(P<0.05);双能量CT和血清ESR、UA水平评估GA急性发作的AUC为0.927,预测敏感度、特异度为94.00%、74.00%。结论GA急性期、间歇期患者双能量CT结果、血清ESR、UA水平存在明显差异,其联合评估GA急性发作具有一定参考价值,可为临床评估患者急性期、间歇期提供依据。Objective To investigate the difference and clinical significance of dual-energy CT and serum erythrocyte sedimentation rate(ESR)and uric acid(UA)in acute and intermittent primary gouty arthritis(GA).Methods Fifty patients with acute stage of GA(acute stage group),50 patients with intermittent stage of GA(intermittent stage group)and 50 healthy volunteers(control group)from September 2021 to January 2023 were selected from Cangzhou Hospital of Integrated Chinese and Western Medicine in Hebei Province.The quantitative and qualitative results of dual-energy CT and serum ESR and UA levels of the three groups were compared and analyzed.The factors of GA acute attack were analyzed by multi-factor analysis.The value of dual-energy CT and serum ESR and UA levels in evaluating GA acute attack was analyzed by receiver operating characteristic(ROC)curve.Results The average total number of gout crystals,the volume of gout crystals on both feet,the volume of gout crystals on both feet,the volume of gout crystals on both hands,and the proportion of joint effusion patients in the acute stage group were higher than those in the intermitent stage group and control group(P<0.05).The average total number of gout crystals,the volume of gout crystals on both feet,the volume of gout crystals on both feet,the volume of gout crystals on both hands,the proportion of bone destruction patients and the proportion of joint effusion patients in intermittent group were higher than those in control group(P<0.05).Serum ESR and UA levels in acute stage group were higher than those in intermittent stage group>control group(F=109.203,287.820,P<0.05).The average total number of gout crystals,the volume of gout crystals on both feet,the volume of gout crystals on both feet,the volume of gout crystals on both hands,the level of ESR and UA in serum were the risk factors for GA acute attack(P<0.05).The AUC assessed by dual-energy CT and serum ESR and UA levels was 0.927,and the prediction sensitivity and specificity were 94.00%and 74.00%.Conclusion The

关 键 词：痛风性关节炎 急性期 间歇期 双能量CT 红细胞沉降率 尿酸 

分 类 号：R684.3[医药卫生—骨科学]