高频超声对类风湿关节炎早期诊断及与实验室指标的相关性研究(1)
[摘要] 目的 探讨高频超声(HF)对早期类风湿关节炎(RA)的诊断价值，并分析其与实验室指标的相关性。 方法 回顾性分析2014年6月～2017年6月在贵州医科大学附属白云医院、贵州医科大學附属医院就诊，符合2010美国风湿病协会/欧洲抗风湿病联盟(ACR/EULAR)分类标准的RA患者45例，同期选择至少一个滑膜炎表现，但不符合2010 ACR/EULAR分类标准的非RA患者45例作为对照。高频超声观察两组患者28个关节的关节积液、滑膜厚度、滑膜内血流信号和骨侵蚀，并对上述4项指标进行半定量评分(0～3分)，28个关节评分的总和即为超声评分，比较两组患者的超声评分差异。同时检测患者的类风湿因子(RF)、抗环瓜氨酸肽抗体(anti-CCP)、C反应蛋白(CRP)和红细胞沉降率(ESR)，采用Spearman相关分析超声评分与上述实验室指标的相关性。 结果 ①与非RA组比较，RA组超声评分的4项指标关节积液、滑膜厚度、血流信号、骨侵蚀评分以及超声评分均明显升高(P < 0.05)；②与非RA组比较，RA组的RF值、抗CCP值、CRP和ESR亦明显升高，差异有统计学意义(P < 0.05)；③非RA组的超声评分与RF、抗CCP、CRP和ESR均无明显相关性(P > 0.05)，而RA组的超声评分与RF、抗CCP和ESR成正相关(P < 0.05)。 结论 高频超声可观察到RA患者的早期病变，并与RF、抗CCP、CRP和ESR实验室指标具有显著正相关性，可作为诊断早期RA的有效方法。
[关键词] 超声；类风湿关节炎；早期诊断；相关性
[中图分类号] R445.1 [文献标识码] A [文章编号] 1673-7210(2018)05(b)-0093-04
Correlation study of high frequency ultrasonography in early diagnosis and laboratory index of rheumatoid arthritis
XU Jun FENG Zhipeng MA Yan TENG Shaohua WANG Yinqi LONG Xiaona PENG Hongying
Department of Nephrotic Rheumatism， the Affiliated Baiyun Hospital of Guizhou Medical University， Guizhou Province， Guiyang 550014， China
[Abstract] Objective To explore the value of early diagnosis of high frequency ultrasound (HF) on rheumatoid arthritis (RA)， and analyze its correlation with the laboratory index. Methods Forty-five cases of RA [according to 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria] treated in the Affiliated Baiyun Hospital of Guizhou Medical University and Affiliated Hospital of Guizhou Medical University from June 2014 to June 2017 were analyzed retrospectively. During the same period， 45 cases with at least one joint synovitis， not diagnosed with RA were selected as non-RA control group. HF was used to observe 28 joints in both group， including hydrops articuli， synovial thickness， blood flow signals and bone erosion， and the 4 indicators were semi quantitative scored (0-3 scores). The ultrasonic scores were the sum of 28 joints， then the ultrasonic scores of 2 groups were compared. At the same time， rheumatoid factor (RF)， anti cyclic citrullinated peptide antibody (anti-CCP)， CRP and erythrocyte sedimentation rate (ESR) were detected. Spearman correlation analysis was used to evaluate the correlation between ultrasonic scores and the laboratory indices. Results ①Compared with non-RA group， joint effusion， synovial thickness， blood flow signals， bone erosion and ultrasonic scores of RA group were increased significantly (P < 0.05)； ②compared with non-RA group， the RF， anti-CCP， CRP and ESR of RA group were also significantly increased (P < 0.05)； ③in non-RA group there was no significant correlation of the ultrasonic scores with RF， anti-CCP， CRP and ESR (P > 0.05)， while the ultrasound scores in RA group were positively correlated with RF， anti-CCP and ESR (P < 0.05). Conclusion HF can detect early lesions in RA diagnosis， and has a significantly positive correlation with laboratory indices as RF， anti-CCP， CRP and ESR. It can be used as an effective method for RA early diagnosis., 百拇医药(许俊 冯志鹏 马燕 腾绍桦 王荫琪 龙晓娜 彭红英)
[关键词] 超声；类风湿关节炎；早期诊断；相关性
[中图分类号] R445.1 [文献标识码] A [文章编号] 1673-7210(2018)05(b)-0093-04
Correlation study of high frequency ultrasonography in early diagnosis and laboratory index of rheumatoid arthritis
XU Jun FENG Zhipeng MA Yan TENG Shaohua WANG Yinqi LONG Xiaona PENG Hongying
Department of Nephrotic Rheumatism， the Affiliated Baiyun Hospital of Guizhou Medical University， Guizhou Province， Guiyang 550014， China
[Abstract] Objective To explore the value of early diagnosis of high frequency ultrasound (HF) on rheumatoid arthritis (RA)， and analyze its correlation with the laboratory index. Methods Forty-five cases of RA [according to 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria] treated in the Affiliated Baiyun Hospital of Guizhou Medical University and Affiliated Hospital of Guizhou Medical University from June 2014 to June 2017 were analyzed retrospectively. During the same period， 45 cases with at least one joint synovitis， not diagnosed with RA were selected as non-RA control group. HF was used to observe 28 joints in both group， including hydrops articuli， synovial thickness， blood flow signals and bone erosion， and the 4 indicators were semi quantitative scored (0-3 scores). The ultrasonic scores were the sum of 28 joints， then the ultrasonic scores of 2 groups were compared. At the same time， rheumatoid factor (RF)， anti cyclic citrullinated peptide antibody (anti-CCP)， CRP and erythrocyte sedimentation rate (ESR) were detected. Spearman correlation analysis was used to evaluate the correlation between ultrasonic scores and the laboratory indices. Results ①Compared with non-RA group， joint effusion， synovial thickness， blood flow signals， bone erosion and ultrasonic scores of RA group were increased significantly (P < 0.05)； ②compared with non-RA group， the RF， anti-CCP， CRP and ESR of RA group were also significantly increased (P < 0.05)； ③in non-RA group there was no significant correlation of the ultrasonic scores with RF， anti-CCP， CRP and ESR (P > 0.05)， while the ultrasound scores in RA group were positively correlated with RF， anti-CCP and ESR (P < 0.05). Conclusion HF can detect early lesions in RA diagnosis， and has a significantly positive correlation with laboratory indices as RF， anti-CCP， CRP and ESR. It can be used as an effective method for RA early diagnosis., 百拇医药(许俊 冯志鹏 马燕 腾绍桦 王荫琪 龙晓娜 彭红英)
参见：首页 > 医疗版 > 疾病专题 > 骨科 > 慢性非化脓性关节炎或关节病 > 类风湿性关节病