高频能量多普勒超声对中重度活动期类风湿关节炎的疗效评估被引量：21

Evaluation of curative effect of rheumatoid arthritis in the moderately severe active period by high frequency power Doppler ultrasound

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摘要目的应用高频能量多普勒超声探测中重度活动期类风湿关节炎（rheumatoid arthritis，RA）患者治疗前后双手情况，分析超声结果与其他活动性指标的相关性。方法收集中重度活动期RA患者35例，分别在治疗前（基线水平）、治疗3个月、6个月进行双手超声检查，观察滑膜、屈／伸肌腱鞘、能量多普勒信号及骨质情况，同时记录患者的临床资料、实验室结果及视觉模拟评分（VAS）、28个关节活动度评分（DAS28）、健康评估问卷（HAQ）评分。结果与治疗前相比，治疗后患者肿胀关节数（TJc）、压痛关节数（SJC）、血沉（EsR）、c反应蛋白（cRP）、VAS、DAS28、HAQ均明显下降，滑膜增生、滑膜炎、腱鞘炎均减轻，滑膜增生、滑膜炎、腱鞘炎评分与DAS28、CRP呈正相关；骨侵蚀在治疗前与CRP呈正相关，在治疗后与DAS28、CRP、HAQ呈正相关。结论高频能量多普勒超声检测滑膜增生、滑膜炎、腱鞘炎可以反映疾病活动状态，对评估中重度活动期RA患者的疗效有重要参考价值。 Objective To observe the change of wrists and fingers of patients with rheumatoid arthritis（RA） in the moderately severe active period before and after treatment by high frequency power Doppler ultrasound, and analyze relationship between ultrasound parameter and other clinical indexes. Methods Thirty-five patients with moderately severe active period of RA were involved. Ultrasonography were performed to scan wrists and fingers of RA patients at baseline, 3 months and 6 months after treatment. The synovial membrane, flexor/extensor tendon sheath, power Doppler signal and bone cortex were observed. At the same time, clinical indexes, laboratory indicators, visual analog scale（VAS）, 28-joint disease activity score （DAS28） and health assessment questionnaire （HAQ） were recorded. Results Compared with those befor treatment, tender joint count （TJC）, swollen joint courtt （SJC）, erythrocyte sedimentation rate （ESR）, C reactive protein （CRP）, VAS, DAS28, HAQ were reduced and hypertrophic synovium,synovitis and tenosynovitis scores were also improved after treatment. There were significant correlation between hypertrophic synovium, synovitis, tenosynovitis scores and DAS28, CRP. Bone erosion was correlated with CRP before treatment, and were correlated with CRP, DAS28, HAQ after treatment. Conclusions Hypertrophic synovium, synovitis, tenosynovitis can evaluate curative efficacy in moderately severe active period of RA patients.

作者孙超张悦彭晨星郭惠芳齐晅高丽霞张明峰马丽艳田玉

机构地区河北医科大学第二医院风湿免疫科

出处《中华超声影像学杂志》 CSCD 北大核心 2016年第8期719-722,共4页 Chinese Journal of Ultrasonography

基金河北省卫生厅科研基金项目（ZL20140070）

关键词超声检查多普勒关节炎类风湿治疗结果 Ultrasonography, Doppler Arthritis, rheumatoid Treatment outcome

分类号 R593.22 [医药卫生—内科学]

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