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发生骨侵蚀的早期银屑病关节炎患者的临床特征

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目的:探讨早期PsA发生骨侵蚀患者的临床特征及相关因素。方法:选取2018 年1 月至2023 年1 月住院治疗的早期PsA(关节炎病程≤1 年)患者50 例,采用彩色多普勒超声仪对患者外周关节进行超声检查,分析发生骨侵蚀的部位及特征,根据超声下有无骨侵蚀分为骨侵蚀组及无骨侵蚀组,分析两组间年龄、性别、病程、血沉、C反应蛋白等临床和实验室参数以及超声影像等的差异。结果:50例PsA患者中23 例(46。00%)存在骨侵蚀,27 例(54。00%)无骨侵蚀,骨侵蚀组较无骨侵蚀组受累外周关节数更多(P<0。05)。骨侵蚀组手、足关节受累及附着点炎发生率均明显高于无骨侵蚀组(P<0。05)。两组间在年龄、性别、病程、皮疹是否先发、中轴关节是否受累、HLA-B27 的阳性率及炎性指标等方面均无统计学差异(P>0。05)。手、足关节受累、附着点炎、受累外周关节数与骨侵蚀呈正相关。结论:骨侵蚀在早期PsA患者较为多见,最常发生于手、足关节,并与附着点炎及受累外周关节数密切相关。
Clinical Characteristics of Patients with Early Psoriatic Arthritis and Bone Erosion
Objective:To explore the clinical characteristics and related factors of patients with early Psoriatic Arthritis(PsA)who develop bone erosion.Methods:Fifty patients with early PsA(disease duration≤1 year)hospitalized from January 2018 to January 2023 were selected.Peripheral joints of patients were examined using color Doppler ultrasonography to analyze the location and features of bone erosion.Based on the presence or absence of bone erosion on ultrasound,patients were categorized into the bone erosion group and the non-bone erosion group.The differences in clinical and laboratory parameters,as well as ultrasound images,between the two groups,were analyzed,including age,gender,disease duration,erythrocyte sedi-mentation rate(ESR),C-reactive protein(CRP),and others.Results:Among the 50 PsA patients,23(46.00%)had bone erosion,while 27(54.00%)did not.The bone erosion group had involvement of a higher number of peripheral joints compared to the non-bone erosion group(P<0.05).The prevalence of in-volvement in hand and foot joints and enthesitis was significantly higher in the bone erosion group(P<0.05).No statistically significant differences were found between the two groups in terms of age,gender,disease du-ration,pre-existing skin rash,axial joint involvement,HLA-B27 positivity,and inflammatory markers(P>0.05).Involvement of hand and foot joints,enthesitis,and the number of affected peripheral joints were posi-tively correlated with bone erosion.Conclusion:Bone erosion is more common in patients with early PsA,most frequently occurring in hand and foot joints,and is closely associated with enthesitis and the number of affected peripheral joints.

Psoriatic arthritisBone erosionJoint ultrasound

张颖、王俊祥

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河北医科大学第三医院风湿免疫科, 河北 石家庄 050051

银屑病关节炎 骨侵蚀 关节超声

河北省医学科学研究重点课题

20180468

2024

河北医学
河北省医学会

河北医学

CSTPCD
影响因子:1.915
ISSN:1006-6233
年,卷(期):2024.30(3)
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