摘要
目的 探讨超声造影(CEUS)检查在类风湿关节炎患者中的早期诊断及与预后的相关性.方法 选取类风湿性关节炎患者 48 例,均行CEUS检查,检测治疗前CDFI、CEUS分级与 28 个关节疾病活动指数(28 joint disease activ-ity index,DAS28)评分的关系;对于确诊患者均行常规方法治疗,3 个月后评估效果;采用Pearson相关性分析软件对超声造影检查结果与生化指标进行相关分析.结果 48 例患者治疗前DAS28 评分分级显示:0 级 8 例、Ⅰ级 13 例,Ⅱ级 11 例及Ⅲ级 16 例.CEUS分级结果与DAS28 评分具有相关性,Kappa值为 0.547(P<0.05);患者治疗后滑膜面积、峰值强度、曲线下面积、半降时间、内洗斜率均低于治疗前,达峰时间长于治疗前,差异有统计学意义(P<0.05);患者治疗 3 个月后RF、CRP、ESR及抗CCP水平均低于治疗前,差异有统计学意义(P<0.05);Pearson相关性分析结果表明:类风湿关节炎患者RF、CRP、ESR及抗CCP水平与滑膜面积、峰值强度、曲线下面积、半降时间、内洗斜率呈正相关性(P<0.05);与达峰时间呈负相关性(P<0.05).结论 CEUS检查用于类风湿关节炎患者早期能准确的评估关节滑膜炎活动性,其CEUS指标与预后存在强相关性,可为临床治疗方案的制订、病情判断及疗效评估提供客观依据.
Abstract
Objective To explore the early diagnosis of contrast-enhanced ultrasound(CEUS)in patients with rheumatoid arthritis and its correlation with prognosis.Methods 48 patients with rheumatoid arthritis admitted were selected as the sub-jects,all of whom underwent CEUS examination.The relationship between CDFI,CEUS grading,and 28 Joint Disease Activity Index(DAS28)scores before treatment was tested;For confirmed patients,routine treatment was performed and the patient's ef-fectiveness was evaluated after 3 months;Pearson correlation analysis software was used to analyze the correlation between ultra-sound contrast examination results and biochemical indicators.Results The DAS28 score grading of 48 patients before treat-ment showed 8 cases at level 0,13 cases at level Ⅰ,11 cases at level Ⅱ,and 16 cases at level Ⅲ.The CEUS grading results were correlated with the DAS28 score,with a Kappa value of 0.547(P<0.05);After treatment,the synovial area,peak intensity,area under the curve,half descent time,and internal washing slope of the patient were all lower than those before treatment(P<0.05);The peak time was longer than before treatment(P<0.05);After 3 months of treatment,the levels of RF,CRP,ESR,and anti CCP in patients were lower than those before treatment(P<0.05);The Pearson correlation analysis results showed that the levels of RF,CRP,ESR,and anti CCP in rheumatoid arthritis patients were positively correlated with synovial area,peak in-tensity,area under the curve,half time of decline,and washout slope(P<0.05);There was a negative correlation with the peak time(P<0.05).Conclusion CEUS can accurately evaluate the activity of synovitis in patients with rheumatoid arthritis in the early stage,and its contrast-enhanced ultrasound indicators have a strong correlation with prognosis.It can provide objective ba-sis for clinical treatment plan formulation,disease judgment,and efficacy evaluation.
基金项目
浙江省医药卫生科技计划项目(2021KY1098)
NETL
NSTL
万方数据