河北医科大学学报

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高频超声在类风湿关节炎疗效监测中的量化应用

  

  1. 广东省惠州市中心人民医院风湿免疫科,广东 惠州 516001
  • 出版日期:2019-07-25 发布日期:2019-07-16
  • 作者简介:庄宇(1978-),男,广东惠州人,广东省惠州市中心人民医院副主任医师,医学硕士,从事风湿免疫性疾病诊治研究。
  • 基金资助:
    广东省医学科学技术研究基金项目(A2015188)

Quantitative application of high frequency ultrasound in monitoring the curative effect of rheumatoid arthritis#br#

  1. Department of Rheumatism and Immunology, the Central People′s Hospital of Huizhou, Guangdong Province, Huizhou 516001, China
  • Online:2019-07-25 Published:2019-07-16

摘要: [摘要]〓
〖HTH〗目的〖HTSS〗〖KG*2〗观察高频超声在类风湿关节炎(rheumatoid arthritis,RA)疗效监测中的量化应用。
〖HTH〗方法〖HTSS〗〖KG*2〗收集RA患者60例,于治疗前、缓解期及缓解后半年进行高频超声检查,观察7个特定关节的滑膜厚度、超声灰阶(gray scale,GS)评分、血流能量多普勒(power Doppler,PD)评分,检测血红细胞沉降率、C反应蛋白、类风湿因子水平,分析关节滑膜改变与炎症指标的相关性。
〖HTH〗结果〖HTSS〗〖KG*2〗60例RA患者共检查840个关节,治疗后缓解期和缓解后半年7个关节关节滑膜厚度、GS评分、血流PD评分、红细胞沉降率、C反应蛋白、类风湿因子水平均明显小于或低于治疗前,缓解后半年7个关节关节滑膜厚度、GS评分、PD评分、红细胞沉降率、C反应蛋白、类风湿因子水平均明显小于或低于缓解期(P<005)。关节滑膜厚度和滑膜血流与红细胞沉降率、C反应蛋白、类风湿因子均呈正相关(P<005)。
〖HTH〗结论〖HTSS〗〖KG*2〗高频超声在RA疗效监测中有确定意义,简化的7个关节GS及PD量化评分变化与炎症指标、类风湿因子滴度的变化趋势呈正相关,对制定及调整RA的治疗方案具有重要的指导意义。

关键词: 关节炎, 类风湿, 高频超声, 疗效监测

Abstract: [Abstract]〓Objective〖HTSS〗〓To investigate the quantitative application of high frequency ultrasound in monitoring the curative effect of rheumatoid arthritis. 
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty patients with RA were examined by highfrequency ultrasound before treatment, during remission and half a year after remission. Synovial thickness, gray scale(GS) and power Doppler(PD) scores of seven specific joints were observed. Erythrocyte sedimentation rate, Creactive protein and rheumatoid factor levels were measured. The correlation between synovial changes and inflammatory indexes was analyzed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with 840 joint ultrasound images of 60 cases of RA patients, synovial membrane thickness and GS score, blood flow PD score, erythrocyte sedimentation rate, Creactive protein and rheumatoid factor levels of 7 joints in remission period after treatment and half a year after remission were significantly lower than or lower than those before treatment. Six months after remission, synovial membrane thickness and GS score, PD score, erythrocyte sedimentation rate, Creactive protein and rheumatoid factor of 7 joints were significantly lower than those before treatment. The levels were significantly lower than or below the remission stage(P<005). The synovial membrane thickness and synovial blood flow were positively correlated with erythrocyte sedimentation rate, Creactive protein and rheumatoid factor(P<005). 
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓High frequency ultrasound shows definite significance in the monitoring of rheumatoid arthritis. Simplified GS and PD quantitative scores of 7 joints are positively correlated with inflammation index and rheumatoid factor titer. It has important guiding significance for formulating and adjusting the therapeutic scheme of rheumatoid therapy.

Key words: arthritis, rheumatoid; high frequency ultrasound, efficacy monitoring