摘要
目的探讨7关节超声评分法(7-joints ultrasound score,US7)中的滑膜炎评分对早期类风湿性关节炎(rheumatoid arthritis,RA)患者临床缓解后短期复发风险的预测价值。方法选择早期RA患者132例,均在进行抗风湿药物治疗后达到临床缓解,即疾病活动性评分(disease activity score in 28 joints,DAS28)<2.6,并连续维持≥6个月。根据12个月随访期内是否复发分为复发组和未复发组。比较两组随访基线时的US7滑膜炎评分差异,并应用ROC曲线评估US7滑膜炎评分对RA患者临床缓解后短期复发风险的预测效能。结果复发组与未复发组的能量多普勒(PD)滑膜炎关节数、PD评分以及滑膜炎总评分差异均有统计学意义(P<0.01或0.05),其中PD评分的AUC最大(0.772)。以PD评分≥1作为是否复发的预测临界值,灵敏度62.9%,特异度80.4%。结论 US7滑膜炎评分法,尤其是PD评分对RA临床缓解后短期复发具有良好的预测效能。
Objective To evaluate the value of ultrasound synovitis score in predicting relapse of rheumatoid arthritis(RA)patients with clinical remission. Methods One hundred and thirty two RA patients with a disease activity DAS28 score≤2.6 at least 6 months were followed for 12 months, and the relapse was defined as DAS>2.6 at the follow-up visit. The US7 synovitis scores were recorded and compared between the relapse patients and non-relapse patients. Results There were significant differences in power Doppler(PD) joint counts,PD scores and synovitis total scores (2 vs 0, 2 vs 0, 6 vs 4; all P<0.05) between relapse and non-relapse groups. The area under ROC curve(AUC) of PD scores was 0.772; when set PD scores≥1 as a cut-off point, the sensitivity and specificity in predicting relapse were 62.9% and 80.4%, respectively. Conclusion Ultrasound synovitis scores, especially PD scores may predict relapse of RA patients in clinical remission.
作者
侯春杰
汤靖岚
何跟山
何洪峰
胡巧洪
刘莹
张帆
范小明
HOU Chunjie;TANG Jinglan;HE Genshan(Department of Ultrasonography,Zhejiang Provincial People's Hospital,People's Hospital of Hangzhou Medical College,Hangzhou 310014,China)
出处
《浙江医学》
CAS
2018年第23期2525-2528,共4页
Zhejiang Medical Journal
基金
浙江省科技厅公益项目(2017C33097)
浙江省卫计委一般项目A类(2015KYA022)
浙江省卫计委一般项目B类(2016KYB019)
