超声联合临床在评估强直性脊柱炎前胸壁关节受累中的应用
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摘要
目的探讨强直性脊柱炎(AS)患者前胸壁受累的主要关节、超声特征及临床症状。方法前瞻性分析45例AS患者为病例组,50例健康者为对照组。超声评估内容:滑膜增生、血流信号、关节积液、骨破坏及骨融合,出现一项及以上定义为超声阳性。临床症状:疼痛和肿胀,出现一项及以上定义为临床阳性。结果 AS前胸壁受累较常见于双侧胸锁关节。两组的滑膜增生、血流信号及骨破坏比较差异均有统计学意义(P<0.05)。病例组超声及临床均阳性占17.8%,仅超声阳性占26.6%。结论 AS前胸壁受累较常见于胸锁关节;主要超声特征为滑膜增生、血流信号和骨破坏;超声较临床有更多的阳性发现。
Objective To investigate the main joints,the feature of ultrasound and clinical symptoms of the anterior chest wall in cases of ankylosing spondylitis(AS).Methods This prospective study included case group of 45 AS patients and control group of 50 healthy persons.Ultrasound assessed synovial hyperplasia,blood signal,joint effusion,bone erosion and ankylosis.Clinical symptoms contained pain and swelling.The definition of positive was more than one features.Results The main involved joint of the anterior chest wall was bilateral SCJ in AS.There were all statistically distinction between two groups in synovial hyperplasia,blood signal and bone destruction.In the case group,the rate of both ultrasound and clinical positive was 17.8%.Only 26.6% of the cases were sonographically positive.Conclusions The main involved joint of the anterior chest wall was SCL in AS,mainly with ultrasound feature of synovial hyperplasia,blood signal and bone destruction.Ultrasound can detect more positive findings than clinic.
Objective To investigate the main joints,the feature of ultrasound and clinical symptoms of the anterior chest wall in cases of ankylosing spondylitis(AS).Methods This prospective study included case group of 45 AS patients and control group of 50 healthy persons.Ultrasound assessed synovial hyperplasia,blood signal,joint effusion,bone erosion and ankylosis.Clinical symptoms contained pain and swelling.The definition of positive was more than one features.Results The main involved joint of the anterior chest wall was bilateral SCJ in AS.There were all statistically distinction between two groups in synovial hyperplasia,blood signal and bone destruction.In the case group,the rate of both ultrasound and clinical positive was 17.8%.Only 26.6% of the cases were sonographically positive.Conclusions The main involved joint of the anterior chest wall was SCL in AS,mainly with ultrasound feature of synovial hyperplasia,blood signal and bone destruction.Ultrasound can detect more positive findings than clinic.
引文
[1] CHRISTIAN E A,JOACHIM S,IN-HO S,et al.Comparison of clinical examination versus whole-body magnetic resonance imaging of enthesitis in patients with early axial spondyloarthritis during 3 years of continuous etanercept treatment[J].J Rheumatol,2016,43(3):618-624.
[2]吕浩源,王前江,江新,等.超声骶髂关节检查对强直性脊柱炎诊断作用的Meta分析[J].中国医药导报,2018,15(3):64-69.
[3]马力,周苏晋,郭云怀,等.肌腱附着点超声在强直性脊柱炎早期诊断中的临床价值[J].医学影像学杂志,2017,27(3):575-577.
[4] FRANK V,XAVIER G, MARIE G V,et al.Ultrasonographic evaluation of the anterior chest wall in spondyloarthritis:aprospective and controlled study[J].J Rheumatol,2015,42(1):87-92.
[5]谢海琴,张威威,陈香梅,等.超声评估强直性脊柱炎胸锁关节受累情况[J].中国超声医学杂志,2018,34(3):214-216.
[2]吕浩源,王前江,江新,等.超声骶髂关节检查对强直性脊柱炎诊断作用的Meta分析[J].中国医药导报,2018,15(3):64-69.
[3]马力,周苏晋,郭云怀,等.肌腱附着点超声在强直性脊柱炎早期诊断中的临床价值[J].医学影像学杂志,2017,27(3):575-577.
[4] FRANK V,XAVIER G, MARIE G V,et al.Ultrasonographic evaluation of the anterior chest wall in spondyloarthritis:aprospective and controlled study[J].J Rheumatol,2015,42(1):87-92.
[5]谢海琴,张威威,陈香梅,等.超声评估强直性脊柱炎胸锁关节受累情况[J].中国超声医学杂志,2018,34(3):214-216.