秦毅,武國良



[摘要] 目的 探究肌骨超聲在類風濕關節炎評估中的應用價值。 方法 2016年12月—2018年12月從該院便利選取106例類風濕關節炎患者,根據患者是否處于疾病的活動期,將患者分為兩組,緩解期組和活動期組,每組53例患者,緩解期組DAS28評分低于3.2分,活動期組的DAS28評分不低于3.2分。觀察比較兩組患者的超聲評分和相關血液學指標,分析活動期患者超聲評分與相關血液學指標、DAS28評分的相關性,以及超聲評分對類風濕關節炎緩解和活動鑒別的診斷價值。 結果 緩解期組患者的超聲評分為(11.5±4.6)分,腫瘤壞死因子-α(TNF-α)為(12.9±2.3) ng/L,C-反應蛋白(CRP)為(6.6±1.5 )mg/L,活動期組患者的超聲評分為(22.3±3.7)分,腫瘤壞死因子-α(TNF-α)為(19.3±4.7) ng/L,C-反應蛋白(CRP)為(18.2±2.7) mg/L,兩組數據差異有統計學意義(t=10.526、12.716、15.853,P=0.001、0.001、0.001<0.05)。活動期組患者的超聲評分,與TNF-α、CRP、DAS28評分,有明顯的正相關關系。經過ROC曲線分析,超聲評分診斷患者屬于活動期的特異性83.65%,敏感性88.93%。 結論 肌骨超聲在類風濕關節炎評估中具有重要的應用價值,能夠有效評估患者處于活動期或者緩解期,具有臨床應用價值。
[關鍵詞] 肌骨超聲;類風濕關節炎;應用價值
[中圖分類號] R593.22 ? ? ? ? ?[文獻標識碼] A ? ? ? ? ?[文章編號] 1674-0742(2020)01(c)-0190-03
Analysis of the Application Value of Musculoskeletal Ultrasound in the Evaluation of Rheumatoid Arthritis
QIN Yi, WU Guo-liang
Department of Ultrasound, Rongcheng People's Hospital of Shandong Province, Rongcheng, Shandong Province, 264300 China
[Abstract] Objective To explore the value of musculoskeletal ultrasound in the evaluation of rheumatoid arthritis. Methods 106 patients with rheumatoid arthritis were convenienty selected from December 2016 to December 2018 in the hospital. According to whether the patients were in the active stage of the disease, the patients were divided into two groups, the remission group and the active stage group, 53 patients in each group, the DAS28 score of the remission group was lower than 3.2 points, and the DAS28 score of the active stage group was not lower than 3.2 points. Observe and compare the two groups of patients with ultrasound score and related hematological indicators, analyze the correlation between ultrasound score and related hematological indicators, DAS28 score, and the value of ultrasound score in the diagnosis of rheumatoid arthritis remission and activity differentiation. Results Patients in the remission phase had an ultrasound score of (11.5±4.6)points, tumor necrosis factor-α (TNF-α) was (12.9±2.3) ng/L, and C-reactive protein (CRP) was (6.6±1.5) mg/L. Ultrasound score was (22.3±3.7)points, tumor necrosis factor-α (TNF-α) was (19.3±4.7) ng/L, and C-reactive protein (CRP) was (18.2±2.7) mg/L. There was statistically significant difference between the two groups (t=10.526, 12.716, 15.853, P=0.001, 0.001, 0.001<0.05). There was a significant positive correlation between ultrasound scores of patients in the active group and TNF-α, CRP, and DAS28 scores. After ROC curve analysis, the specificity of patients diagnosed by ultrasound score was 83.65%, and the sensitivity was 88.93%. Conclusion Myoskeletal ultrasound has important application value in the evaluation of rheumatoid arthritis. It can effectively evaluate patients in active or remission stage, and has clinical application value.
[Key words] Musculoskeletal ultrasound; Rheumatoid arthritis; Application value
類風濕關節炎是一種免疫性系統性疾病,多見于女性患者。類風濕關節炎的主要病理改變是關節滑膜非特異性、慢性炎癥,具有進行性、侵襲性的特點,并且有一定的致殘性,嚴重影響患者的正常生活[1]。目前尚不明確類風濕關節炎的發病機制,大多認為與環境污染、遺傳易感等有關。對類風濕關節炎及早診斷,及時治療,有利于提高患者的生活質量,提高預后。超聲檢查是一種操作簡單、無痛的方式,隨著超聲技術的發展,肌骨超聲檢查在類風濕關節炎中廣泛應用[2]。為探究肌骨超聲在類風濕關節炎評估中的應用價值,便利選取2016年12月—2018年12月該院收治的106例患者進行研究,現報道如下。……