| 高频超声检查在强直性脊柱炎患者髋关节受累诊断中的临床价值 |
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投稿时间：2023-08-09
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| 作者 | Author | 单位 | Address | E-Mail |
| 薛国艳 |
XUE Guo-yan |
山西省运城市中心医院超声医学科, 山西 运城 044000 |
Ultrasound Medicine Department of Yuncheng Central Hospital, Yuncheng 044000, Shanxi, China |
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| 李瑛琪 |
LI Ying-qi |
山西省运城市中心医院超声医学科, 山西 运城 044000 |
Ultrasound Medicine Department of Yuncheng Central Hospital, Yuncheng 044000, Shanxi, China |
lyq_dh@126.com |
| 王锐 |
WANG Rui |
山西省运城市中心医院超声医学科, 山西 运城 044000 |
Ultrasound Medicine Department of Yuncheng Central Hospital, Yuncheng 044000, Shanxi, China |
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| 王文杏 |
WANG Wen-xing |
山西省运城市中心医院内分泌科, 山西 运城 044000 |
Endocrinology Department of Shanxi Yuncheng Central Hospital, Yuncheng 044000, Shanxi, China |
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| 董壮 |
DONG Zhuang |
山西省运城市中心医院设备科, 山西 运城 044000 |
Equipment Section Department of Shanxi Yuncheng Central Hospital, Yuncheng 044000, Shanxi, China |
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| 丁建峰 |
DING Jian-feng |
山西省运城市中心医院医学影像科, 山西 运城 044000 |
Medical Imaging Department of Shanxi Yuncheng Central Hospital, Yuncheng 044000, Shanxi, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第4期，第374-380页 |
| DOI：10.12200/j.issn.1003-0034.20221291 |
| 基金项目:山西省运城市中心医院院级课题(编号:y72022055) |
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中文摘要:
目的: 分析髋关节肌骨超声评分与强直性脊柱炎(ankylosing spondylitis,AS)疾病活动的相关性,探讨高频超声检查在AS髋关节受累诊断中的价值。
方法: 回顾性分析2019年3月至2022年3月接受诊治的244例AS患者临床资料,其中男174例,女70例,年龄19~58(34.22±9.49)岁;AS病程8个月~26年,平均(13.68±4.04)年。根据是否合并髋关节病变将244例患者分为疾病组83例和对照组161例,并根据疾病活动情况将疾病组患者分为活动期45例和稳定期38例。比较疾病组和对照组、疾病组活动期和稳定期患者超声评分。分析AS患者髋关节受累的相关因素,并分析AS患者超声评分与Bath强直性脊柱炎疾病活动评分(Bath ankylosing spondylitis disease activity score index,BASDAI)、Bath强直性脊柱炎功能指数(Bath ankylosing spondylitis functional index,BASFI)、疼痛视觉模拟评分(visual analog score,VAS)、C反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)的相关性,分析髋关节囊评分、肌腱附着端评分与BASDAI、BASFI、VAS、CRP、ESR的相关性。
结果: 疾病组髋关节囊评分(3.06±1.12)分、股骨头评分(1.45±0.43)分、肌腱附着端评分(3.28±1.30)分及超声总评分(6.65±2.31)分均高于对照组的(1.51±0.48)、(0.66±0.27)、(1.61±0.53)、(3.81±1.44)分(P<0.05)。多因素Logstic回归分析显示患者的病程、髋关节囊评分、超声总评分为AS患者髋关节受累的独立危险因素。疾病组活动期患者髋关节囊评分(3.65±1.22)分、超声总评分(8.28±2.33)分均高于稳定期的(2.48±1.04)、(6.82±1.96)分(P<0.05)。AS患者髋关节囊评分、超声总评分与BASDAI、BASFI、VAS、CRP、ESR均呈正相关(P<0.05,P<0.01);肌腱附着端评分与CRP呈正相关(P<0.05);AS患者关节囊积液评分与BASDAI、BASFI、VAS呈正相关(P<0.05,P<0.01);滑膜血流评分与BASDAI、VAS、CRP、ESR呈正相关(P<0.05,P<0.01);滑膜厚度评分与BASDAI、BASFI、VAS、CRP、ESR均呈正相关(P<0.05,P<0.01)。肌腱附着端评分与BASDAI、BASFI、VAS、CRP、ESR均无相关性。
结论: AS患者髋关节超声评分与临床指标存在相关性,髋关节囊评分、超声总评分为AS患者髋关节受累的独立危险因素,高频超声在AS患者髋关节受累诊断中具有较高的临床价值。 |
| 【关键词】强直性脊柱炎 髋关节 高频超声 |
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| Clinical value of high frequency ultrasound in the diagnosis of hip joint involvement in patients with ankylosing spondylitis |
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ABSTRACT
Objective To analyze the correlation between hip joint musculoskeletal ultrasound score and ankylosing spondylitis (AS) disease activity,as well as to investigate the value of high frequency ultrasound in the assessment of hip joint involvement in AS.
Methods The clinical data of 244 patients with AS who were treated in the rheumatology department of from March 2019 to March 2022 were retrospectively analyzed. Among them,there 174 males and 70 females,aged from 19 to 58 years old with an average of (34.22±9.49) years old;the disease duration of AS patients ranged from 8 months to 26 years,with an average of (13.68±4.04) years.The 244 patients were divided into disease group (83 cases) and control group (161 cases) based in the presence of hip joint involuement. According to the the disease activity,patients in the disease group were further categorezed into active phase (45 cases) and stable phase (38 cases). The ultrasound scores of patients in the active and stable phases of the disease group and the control group were compared. Relevant factors of hip joint involvement in AS patients were analyzed,and analyze the correlation between ultrasound score and Bath ankylosing spondylitis disease activity score index(BASDAI),Bath ankylosing spondylitis functional index(BASFI),visual analogue score of pain (VAS),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),and the correlation between hip joint capsule score and tendon attachment end score and BASDAI,BASFI,VAS,CRP and ESR.
Results The hip joint capsule score(3.06±1.12),femoral head score(1.45±0.43),tendon attachment end score(3.28±1.30) and total ultrasound score(6.65±2.31) of the disease group were higher than those of the control group(1.51±0.48)、(0.66±0.27)、(1.61±0.53)、(3.81±1.44) scores (P<0.05). Multifactor Logstic regression analysis showed that the course of disease,hip joint capsule score and total ultrasound score were independent risk factors for hip involvement in AS patients.The hip capsule score (3.65±1.22)and total ultrasound score(8.28±2.33) in the active phase of the disease group were higher than those in the stable phase (2.48±1.04)、(6.82±1.96) scores(P<0.05). The hip joint capsule score and total ultrasonic score of AS patients were positively correlated with BASDAI,BASFI,VAS,CRP,and ESR (P<0.05,P<0.01).The score of tendon attachment end was positively correlated with CRP (P<0.05). The score of joint capsule effusion in AS patients was positively correlated with BASDAI,BASFI and VAS (P<0.05,P<0.01). The synovial blood flow score was positively correlated with BASDAI,VAS,CRP and ESR (P<0.05,P<0.01). The synovial thickening score was positively correlated with BASDAI,BASFI,VAS,CRP and ESR (P<0.05,P<0.01). There was no correlation between the score of tendon attachment end and BASDAI,BASFI,VAS,CRP and ESR.
Conclusion There is a correlation between hip joint ultrasonic score of hip joint and clinical indexes in AS patients.Hip joint capsule score and total ultrasonic score were independent risk factors for hip involvement in AS patients. High frequency ultrasound exhibits clinical value in the diagnosis of hip joint involvement in AS patients. |
| KEY WORDS Ankylosing spondylitis Hip joint High frequency ultrasound |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 薛国艳,李瑛琪,王锐,王文杏,董壮,丁建峰.高频超声检查在强直性脊柱炎患者髋关节受累诊断中的临床价值[J].中国骨伤,2024,37(4):374~380 |
| 英文格式: | XUE Guo-yan,LI Ying-qi,WANG Rui,WANG Wen-xing,DONG Zhuang,DING Jian-feng.Clinical value of high frequency ultrasound in the diagnosis of hip joint involvement in patients with ankylosing spondylitis[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(4):374~380 |
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