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目的利用超声观察早期类风湿关节炎(ERA)患者目标治疗前后关节滑膜炎症、积液及骨破坏情况。方法对20例ERA患者行目标治疗前及治疗3~6个月后,双侧腕关节、2~5掌指关节及近端指间关节共360个关节进行灰阶及能量多普勒超声扫查,将各关节滑膜炎,积液及骨破坏进行0~3分半定量评分,采用Wilcoxon配对秩和检验,比较治疗前后变化情况。结果超声评估治疗后患者关节滑膜增生明显好转(T=1 858.0,z=-5.584,P=0.000),滑膜血流减少(T=308.0,z=-3.442,P=0.001),积液亦减轻(T=286.5,z=-4.09,P=0.000),差异均有统计学意义。然而骨破坏情况改善不明显(T=123.5,z=-0.468,P=0.64),差异无统计学意义。结论目标治疗后患者滑膜炎、积液情况明显改善,而骨破坏持续或进展。超声结合能量多普勒能够在ERA患者目标治疗中起到很好的疗效监测作用。
Objective To observe the synovial inflammation, effusion and bone destruction in patients with early rheumatoid arthritis (ERA) before and after treatment by ultrasound. Methods Twenty cases of ERA were treated with target gray scale and energy Doppler sonography before and after 3 to 6 months of treatment. 360 joints of bilateral wrist, 2 ~ 5 metacarpophalangeal joints and proximal interphalangeal joint Check, the joint synovitis, effusion and bone destruction 0 ~ 3 points and semi-quantitative score, using Wilcoxon paired rank sum test to compare the changes before and after treatment. Results After the ultrasound evaluation, the synovial hyperplasia of the joint was significantly improved (T = 1 858.0, z = -5.584, P = 0.000), the synovial blood flow decreased (T = 308.0, z = -3.442, P = 0.001) Also reduced (T = 286.5, z = -4.09, P = 0.000), the differences were statistically significant. However, the improvement of bone destruction was not obvious (T = 123.5, z = -0.468, P = 0.64), the difference was not statistically significant. Conclusions After treatment, synovitis and effusion of patients were significantly improved, while bone destruction continued or progressed. Ultrasound combined with energy Doppler can play a good therapeutic effect in the target therapy of ERA.