摘要
目的评估高频超声对膝关节镜滑膜病变及滑膜切除术后的价值。方法选取我院2017年1月~2018年2月收治的类风湿关节炎(RA)患者(以单侧膝关节病变为主)作为研究对象,均行高频超声及MRI检查,分析MRI及超声检查结果,探讨滑膜厚度与病情及预后的关系。结果术前高频超声与MRI对RA患者软骨病变分期结果比较差异无统计学意义(P>0.05)。治疗前及治疗后6、14个月,超声与MRI对于滑膜厚度的测量比较无统计学意义(P>0.05);而在治疗后1、3个月,超声检测结果低于MRI测值(P<0.05)。治疗后患者ESR、CRP、CCP水平,VAS评分及RF阳性率均低于治疗前(均P<0.05);治疗后Lysholm膝关节功能评分明显优于治疗前(P<0.05)。高频超声测量滑膜厚度变化与ESR、RF阳性率及CCP呈正相关(P<0.05);高频超声测量滑膜厚度变化与Lysholm膝关节功能评分呈负相关(P<0.05);高频超声测量滑膜厚度变化与CRP、VAS评分无明显相关性(P>0.05)。治疗后6个月,滑膜厚度低的患者ESR、CCP、VAS评分较低,Lysholm膝关节功能评分较高(P<0.05)。结论高频彩色多普勒超声对类风湿关节炎膝关节病变具有姣好的诊断价值,同时对评估预后具有重要意义,可应用于临床。
Objective To study the value of high frequency ultrasound in knee arthroscopic synovitis and synoviectomy.Methods From January 2017 to February 2018,30 patients with rheumatoid arthritis were studied.All patients were examined by ultrasonography and MRI.The results of MRI and ultrasonography were analyzed,and the relationship between synovial thickness and the condition and prognosis was also discussed.Results There was no statistical difference between the preoperative high-frequency ultrasound and MRI on the stage of cartilage lesions in RA patients(P>0.05).Before and after treatment for 6 months,14 months,ultrasound and MRI measurement for synovial thickness was not statistically significant(P>0.05).In 1 months and 3 months after treatment,the ultrasonic testing results below the detection results of MRI(P<0.05).The levels of ESR,CRP,CCP,VAS and RF were lower than those before treatment(P<0.05).The knee function score of Lysholm after treatment was significantly better than those before treatment(P<0.05).The ultrasound measurement of synovial membrane thickness was positive related to ESR,the positive rate of RF and CCP positive(P<0.05).The ultrasound measurement of synovial membrane thickness was negative related to Lysholm knee function scores(P<0.05).The ultrasound measurement of synovial membrane thickness was not related to CRP and VAS score(P>0.05).At 6 months after treatment,patients with lower synovial thickness had lower ESR,CCP,and VAS scores,and Lysholm knee function scores were higher(P<0.05).Conclusion High frequency color Doppler ultrasound has good diagnostic value of knee joint lesions of rheumatoid arthritis at the same time.It is important to evaluate the prognosis.
作者
罗绮雯
陈国强
张红卫
黎志峰
郭冬梅
余旸弢
林嘉鸿
马绮文
梁燕芳
LUO Qiwen;CHEN Guoqiang;ZHANG Hongwei;LI Zhifeng;GUO Dongmei;YU Yangtao;LIN Jiahong;MA Qiwen;LIANG Yanfang(Department of Rheumatology and Immunology,The First People's Hospital of Foshan,Foshan 528000,Guangdong,China)
出处
《西部医学》
2018年第11期1649-1653,共5页
Medical Journal of West China
基金
佛山市卫生和计生委医学科研课题(20170009)
关键词
高频彩色多普勒超声
类风湿关节炎
滑膜病变
评估病情
High-frequency color Doppler ultrasound
Rheumatoid arthritis
Synovial lesions
Evaluation of the condition
