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目的分析在关节疼痛伴类风湿因子和(或)抗环瓜氨酸肽抗体阳性患者中,超声图像异常与临床关节炎发展的相关性。方法选取关节疼痛伴类风湿因子和(或)抗环瓜氨酸肽抗体阳性患者46例,行临床、实验室及超声检查;随访24个月,根据转归分为关节炎组及无关节炎组,从关节及患者水平分别评估超声表现与关节炎发展的相关性和意义。结果 (1)12例患者在(11.91±4.42)个月后发展为临床关节炎。(2)在关节水平,关节炎组与无关节炎组在超声滑膜增生、能量多普勒信号、骨侵蚀、关节腔积液、腱鞘炎病变方面差异均有统计学意义;在患者水平,两组在超声滑膜增生、能量多普勒信号病变方面差异有统计学意义。结论超声在临床关节炎发生前即可检测到关节局部的亚临床炎症,超声图像的异常与关节炎的发展具有相关性,提示超声有望成为预测关节炎发展的有效工具。
Objective To analyze the correlation between abnormalities of ultrasound images and the development of clinical arthritis in patients with joint pain associated with rheumatoid factor and / or anti-cyclic citrullinated peptide antibody. Methods Forty-six patients with rheumatoid arthritis and rheumatoid factor and / or anti-cyclic citrullinated peptide antibody were selected for clinical, laboratory and ultrasonographic examination. The patients were followed up for 24 months and divided into arthritis group and non-arthritis group Group, respectively, from the joint and patient levels were evaluated ultrasound findings and the relevance and significance of the development of arthritis. Results (1) Twelve patients developed clinical arthritis after (11.91 ± 4.42) months. (2) There were significant differences in synovial membrane hyperplasia, energy Doppler signal, bone erosion, joint effusion and tenosynovitis between the arthritis group and the non-arthritis group at the joint level. At the patient level, Group in the ultrasound synovial hyperplasia, energy Doppler signal pathological differences were statistically significant. Conclusion Ultrasound can detect subclinical inflammation of the joints before the onset of clinical arthritis. The abnormality of ultrasound images is correlated with the development of arthritis, suggesting that ultrasound may be an effective tool to predict the development of arthritis.