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目的:探讨类风湿性关节炎(RA)病人膝、腕关节滑膜关节滑膜的超声检查指标与RA临床指标的相关性。方法:通过高频超声及彩色多普勒超声对RA病人(50例)的膝、腕关节的滑膜情况(包括滑膜厚度、关节积液程度、滑膜彩色血流分级)进行观察,并获取RA患者疾病活动度(DAS28)分值、炎症指标C反应蛋白(CRP)、红细胞沉降率(ESR)、标记性抗体抗瓜氨酸抗体(CCP)和类风湿因子(RF)滴度水平并对上述指标做相关分析。结果:①RA病人膝关节滑膜厚度、关节积液程度、滑膜血流信号分级等级与患者DAS28(r=0.35、r=0.38、r_s=0.54,P<0.05)、CRP(r=0.41、r=0.45、r_s=0.57,P<0.05)、ESR(r=0.38、r=0.42、r_s=0.51,P<0.05)均呈正相关;腕关节滑膜厚度、滑膜血流等级信号与患者DAS28(r=0.55、r_s=0.69,P<0.05)、CRP(r=0.53、r_s=0.67,P<0.05)、ESR(r=0.48、r_s=0.61,P<0.05)均呈正相关,且相关系数高于膝关节组;②膝关节组滑膜厚度与关节积液程度、滑膜血流分级等级均呈正相关(P<0.05),关节积液程度与滑膜血流分级呈正相关(P<0.05);腕关节组滑膜厚度与滑膜血流分级等级均呈正相关(P<0.05);③膝、腕关节之间仅滑膜血流信号等级成等级正相关(P<0.05)。结论:膝、腕关节滑膜超声能较好地观察类风湿性关节炎病人滑膜的病变,其指标能作为一种客观有效的评价疗效、判断疾病活跃性及评估预后的指标,尤其应该以腕关节作为RA病人的优选关节。
Objective: To investigate the correlation between the echocardiographic parameters of synovial synovium and RA in patients with rheumatoid arthritis (RA). Methods: Synovial conditions (including synovial thickness, joint effusion, and synovial color flow classification) of the knee and wrist of RA patients (50 cases) were observed by high-frequency ultrasound and color Doppler ultrasonography. The scores of disease activity (DAS28), CRP, ESR, anti-citrullinated antibody (CCP) and rheumatoid factor (RF) Related to the above indicators. RESULTS: ① The synovial thickness, the level of synovial fluid and the synovial blood flow grade in patients with RA were similar to those in patients with DAS28 (r = 0.35, r = 0.38, r_s = 0.54, P < (R = 0.38, r = 0.42, r_s = 0.51, P <0.05). There was a positive correlation between ESR (r = 0.38, r = 0.42, r_s = 0.51, (r = 0.55, r_s = 0.67, P <0.05), ESR (r = 0.48, r_s = 0.61, P <0.05) and the correlation coefficient was high (P <0.05). There was a positive correlation between the degree of synovial effusion and synovial blood flow (P <0.05) in the knee joint group. (2) The synovial thickness in the knee joint group was positively correlated with the degree of joint effusion and synovial blood flow grade (P <0.05). The level of synovial blood flow signal between the knee joint and wrist was positively correlated (P <0.05). Conclusion: The synovial ultrasound of knee and wrist can better observe the synovial lesions of patients with rheumatoid arthritis, and its index can be used as an objective and effective evaluation of the curative effect, to judge the activity of the disease and to evaluate the prognosis, especially The wrist is the preferred joint for RA patients.