【摘要】：目的： 探討超聲檢查在評估類風(fēng)濕關(guān)節(jié)炎（rheumatoid arthritis，RA）診斷中的應(yīng)用價值。 方法： 77例臨床疑診RA的患者分別進(jìn)行超聲檢查及臨床方法診斷RA。超聲通過檢測患側(cè)腕關(guān)節(jié)，第2、3掌指關(guān)節(jié)(metacarpophalangeal joints,MCP)，第2、3近端指間關(guān)節(jié)(proximal interphalangeal joints, PIP），第2、5跖趾關(guān)節(jié)（metatarsophalangeal joints, MTP）等7個關(guān)節(jié)，觀察滑膜增生、滑膜內(nèi)血流信號、骨侵蝕及關(guān)節(jié)積液4項指標(biāo)，以4步半定量分級系統(tǒng)中滑膜病變?yōu)橹鞯牟±曁崾綬A。對兩種方法進(jìn)行對比分析。同時對這4項指標(biāo)進(jìn)行等級評分，評分總和與同期血清學(xué)指標(biāo)進(jìn)行單因素相關(guān)Pearson分析。 結(jié)果： 超聲提示RA55例，非RA22例，臨床診斷RA53例，非RA24例。超聲提示和臨床診斷兩種方法間的差異無統(tǒng)計學(xué)意義（P=0.774）�；ぱ髟u分總和、積液評分總和與血沉(erythrocyte sedimentationrate，ESR)成正相關(guān)（r值分別是0.739、0.564，P值均=0.000）。 結(jié)論： （1）高頻超聲可較清楚顯示骨質(zhì)破壞、關(guān)節(jié)積液、滑膜增生及增生滑膜內(nèi)血流信號并進(jìn)行超聲分級。 （2）超聲同時應(yīng)用4項指標(biāo)對類風(fēng)濕關(guān)節(jié)炎進(jìn)行提示的方法同臨床診斷基本吻合，且其滑膜血流評分總和及積液評分總和與血清學(xué)指標(biāo)存在正相關(guān)性，超聲可作為RA的篩查方法，，為臨床早期確診提供更多影像學(xué)依據(jù)，值得推廣應(yīng)用。 （3）部分患者超聲提示結(jié)果可以早于實驗室診斷。
[Abstract]:Objective: to evaluate the value of ultrasonography in the diagnosis of rheumatoid arthritis (rheumatoid arthritis,RA). Methods: 77 patients with suspected RA were examined by ultrasound and diagnosed with RA. by clinical methods. Ultrasound was used to detect the synovial hyperplasia and intrasynovial blood flow signal of 7 joints, including wrist joint, metacarpophalangeal joint (metacarpophalangeal joints,MCP), interphalangeal joint (proximal interphalangeal joints, PIP), metatarsophalangeal joint (metatarsophalangeal joints, MTP) and metatarsophalangeal joint (metatarsophalangeal joints, MTP). Four indexes of bone erosion and joint effusion. RA. was revealed by ultrasound in synovial lesions in a four-step semi-quantitative grading system. The two methods are compared and analyzed. At the same time, the four indexes were graded, the sum of the scores and the serological indexes of the same period were analyzed by univariate Pearson. Results: RA55, non-RA22, RA53 and non-RA24 were diagnosed by ultrasonography. There was no significant difference between ultrasound indication and clinical diagnosis (P0. 774). The sum of synovial blood flow score and accumulative fluid score were positively correlated with erythrocyte sedimentationrate,ESR (r = 0. 739 鹵0. 564 P = 0.000). Conclusion: (1) High-frequency ultrasound can clearly display the blood flow signal in synovial membrane of bone destruction, joint effusion, synovial hyperplasia and hyperplasia. (2) the methods of indicating rheumatoid arthritis with four indexes of ultrasound were in good agreement with clinical diagnosis, and the sum of synovial blood flow score and accumulated fluid score were positively correlated with the serological indexes. Ultrasound can be used as a screening method for RA and provide more imaging evidence for clinical early diagnosis. (3) the ultrasonic findings of some patients can be diagnosed earlier than the laboratory diagnosis.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.1

【共引文獻(xiàn)】

相關(guān)期刊論文 前4條

1 何秀珍;王月香;梁峭嶸;黃春燕;李少君;;超聲早期診斷無癥狀高尿酸血癥患者關(guān)節(jié)病變[J];中國介入影像與治療學(xué);2013年09期

2 陳禹;葉迅;;痛風(fēng)性關(guān)節(jié)炎在高頻超聲下的特異性改變和非特異性改變[J];菏澤醫(yī)學(xué)�？茖W(xué)校學(xué)報;2013年04期

3 汪飛;李梁;余成新;;雙能量CT對痛風(fēng)的診斷及評價[J];中國醫(yī)學(xué)影像學(xué)雜志;2014年01期

4 游嵐嵐;鄭元義;王志剛;張萍;周璇;蔣玲;高維;唐琳;;4項指標(biāo)7個關(guān)節(jié)超聲診斷類風(fēng)濕關(guān)節(jié)炎[J];重慶醫(yī)科大學(xué)學(xué)報;2014年10期

相關(guān)碩士學(xué)位論文 前2條

1 王曉梅;高頻超聲在類風(fēng)濕關(guān)節(jié)炎診治方面的應(yīng)用價值[D];天津醫(yī)科大學(xué);2013年

2 李杰;雙源CT雙能量技術(shù)在尿酸鹽沉積的初步應(yīng)用[D];鄭州大學(xué);2014年

本文編號：2426026