| 摘要: |
| 目的 探讨彩色超微血管成像（cSMI）技术获取的滑膜血流显像在类风湿性关节炎（RA）治疗中的应用价值。方法 回顾性分析我院确诊为腕关节类风湿性关节炎住院患者40例，均使用高频超声cSMI及脉冲多普勒（PW）技术动态监测治疗前、后腕关节滑膜内血流分级及动脉阻力指数（RI），同时分别记录治疗前、后反映疗效的血生化指标：类风湿因子（RF）、C反应蛋白（CRP）、红细胞沉降率（ESR）及抗环瓜氨酸肽抗体（CCP），比较上述参数治疗前后变化情况。分析滑膜内血流分级、动脉RI及血生化指标的相关性。结果 患者腕关节滑膜内彩色血流分级及滑膜内动脉RI指标在治疗前、后比较，差异均有统计学意义（均P＜0.05）。相关性分析显示，滑膜内彩色血流分级与反映疗效的血生化指标均呈正相关（彩色血流分级与RF、CRP、ESR、CCP相关系数，治疗前： r=0.648、0.369、0.295、0.624，均Ｐ＜0.05；治疗后： r=0.765、0.559、0.573、0.701，均Ｐ＜0.05），滑膜内动脉RI与反映疗效的血生化指标均呈负相关（滑膜内动脉RI与RF、CRP、ESR、CCP相关系数，治疗前：r=-0.682、-0.420、-0.434、-0.798，均Ｐ＜0.05；治疗后： r=-0.657、-0.549、-0.765、-0.765，均Ｐ＜0.05），滑膜内彩色血流分级与滑膜内动脉RI均呈负相关（治疗前：r=-0.820，Ｐ＜0.05；治疗后：r=-0.811，Ｐ＜0.05）。结论 基于cSMI技术的滑膜彩色血流分级及滑膜动脉RI能动态监测RA患者的治疗效果，为临床提供可靠依据。 |
| 关键词: 超声 彩色超微血管成像 彩色血流分级 动脉阻力指数 类风湿性关节炎 |
| DOI： |
| 投稿时间：2020-09-01修订日期：2021-06-10 |
| 基金项目: |
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| Application Value of Synovial Blood Flow Imaging Based on Color Superb Microvascular Imaging Technology in The Treatment of Rheumatoid Arthritis |
| Qiu Yuewen,JIN Linyuan,ZHANG Yanfen,HUANG Fenghua,SUN Pei |
| (Changsha Central Hospital Affiliated to Nanhua University) |
| Abstract: |
| Objective To investigate the application value of synovial blood flow imaging obtained by Color Superb Microvascular Imaging(cSMI) technology in the treatment of rheumatoid arthritis (RA).Methods Retrospective analysis of 40 hospitalized patients confirmed as wrist rheumatoid arthritis in our hospital.High frequency ultrasound cSMI and pulse doppler（PW） technology were used to dynamically monitor the synovial blood flow classification and arterial resistance index（RI）in wrist before and after treatment for all patients.At the same time，the blood biochemical indexes reflecting the curative effect before and after treatment were recorded respectively: rheumatoid factor (RF), C reactive protein (CRP), erythrocyte sedimentation rate (ESR) and anti cyclic citrullinated peptide antibody (CCP), and the changes of the above parameters before and after treatment were compared.The correlation among blood flow classification, arterial RI in synovium and blood biochemical indexes were analyzed.Results Color flow classification of synovial and RI index of synovial artery in patients with wrist were compared before and after treatment. The differences were statistically significant（all P＜0.05）. Correlation analysis showed that the color flow classification in synovium were all positively correlated with the blood biochemical indexes reflecting the curative effect（correlation coefficients of color flow classification with RF, CRP, ESR and CCP，before treatment：r=0.648、0.369、0.295、0.624，allＰ＜0.05;after treatment: r=0.765、0.559、0.573、0.701，allＰ＜0.05）.There were all negative correlation between RI in the synovial artery and blood biochemical indexes.（correlation coefficient between RI in synovial artery and RF, CRP, ESR and CCP，before treatment：r=-0.682、-0.420、-0.434、-0.798，allＰ＜0.05;after treatment: r=-0.657、-0.549、-0.765、-0.765，allＰ＜0.05).And there were all negative correlation between color flow classification and RI in synovial artery(before treatment：r=-0.820，Ｐ＜0.05;after treatment: r=-0.811，Ｐ＜0.05).Conclusion The color flow classification of synovium and RI of synovial artery based on cSMI technology can dynamically monitor the therapeutic effect of RA patients , so as to provide reliable evidence for clinical practice. |
| Key words: Ultrasound Color superb microvascular imaging Color blood flow classification Arterial resistance index rheumatoid arthritis |
