7关节超声半定量评分评估类风湿关节炎疾病活动度

肖蕾; 王佳佳; 张靖; 王金萍

doi:10.13898/j.cnki.issn.1000-2200.2021.09.019

7关节超声半定量评分评估类风湿关节炎疾病活动度

Value of 7-joint ultrasound semi-quantitative score in the evaluation of rheumatoid arthritis disease activity

摘要

摘要:
目的探讨7关节超声（US7）半定量评分评估类风湿关节炎（RA）疾病活动度的效果。
方法选取37例RA病人，根据超敏C反应蛋白（hs-CRP）水平将RA病人分为hs-CRP正常组（n=14）与hs-CRP升高组（n=23），对2组病人病变严重侧腕关节，第2、3掌指关节，第2、3近端指间关节，第2、5跖趾关节行灰阶超声和能量多普勒超声检查并进行评分，比较2组间评分差异，并分析US7评分与hs-CRP之间的相关性。
结果hs-CRP升高组滑膜增生、滑膜血流评分及US7总分均高于hs-CRP正常组（P < 0.05~P < 0.01），2组间关节积液、骨质侵蚀评分差异均无统计学意义（P>0.05）。37例RA病人中，US7的滑膜血流、骨质侵蚀、US7总分与hs-CRP水平均呈正相关关系（P < 0.01）；滑膜增生、关节积液与hs-CRP水平均无明显相关关系（P>0.05）。
结论US7评分可以评估RA的疾病活动度，是监测RA疾病活动度简单、有效的影像学检查方法。

Abstract:
ObjectiveTo investigate the value of ultrasonic semi-quantitative scoring of 7 joints(US7) in the evaluation of the rheumatoid arthritis(RA) disease activity.
MethodsThirty-seven patients with RA were divided into the hypersensitive C-reactive protein(hs-CRP) normal group(14 cases) and hs-CRP increasing group(23 cases) according to the level of hs-CRP.The severe side wrist joint, second and third metacarpophalangeal joints and proximal interphalangeal joints, and second and fifth metatarsophalangeal joints in two groups were examined by gray-scale ultrasound and energy Doppler ultrasound.The scores were compared between two groups, and the correlation between US7 score and hs-CRP was analyzed.
ResultsThe synovial hyperplasia, synovial blood flow scoring and total US7 score in hs-CRP increasing group were higher than those in hs-CRP normal group(P < 0.05 to P < 0.01).The differences of the scores of joint effusion and bone erosion between two groups were not statistically significant(P>0.05).Among the 37 RA patients, the synovium blood flow, bone erosion and US7 total score were positively correlated with the level of hs-CRP.The synovial hyperplasia and joint effusion were not correlated to the level of hs-CRP(P>0.05).
ConclusionsThe US7 score can be used to evaluate the disease activity of RA, and it is a simple and effective imaging method to monitor the disease activity of RA.

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