| 摘要: |
| 目的：探讨关节超声在血清学阴性类风湿关节炎与骨性关节炎鉴别中的应用价值。方法：对145例膝、肘、腕或近端指间关节疼痛为主诉的OA及SNRA患者进行超声检查，重点关注骨侵蚀、滑膜增厚、滑膜血流信号评估，随访6个月后根据ACR/EULAR做出诊断。比较超声各项指标在SNRA及OA两组患者之间的差异。结果：本研究共纳入145例，共检查425个关节。其中OA组患者75例，检查关节194个；SNRA组患者70个，关节231个。以2-3度骨侵蚀作为判断标准，诊断RA的特异性为93.33%（CI 86.75%至97.28%），敏感性41.82%。0-1度骨侵蚀中滑膜增厚程度、滑膜血流信号差异在SNRA与OA组间差异有显著性（p<0.01）。结论：超声在识别骨侵蚀、滑膜炎等方面对鉴别SNRA与OA有重要意义。 |
| 关键词: 血清学阴性 类风湿关节炎 超声 骨侵蚀 |
| DOI： |
| 投稿时间：2020-09-28修订日期：2021-06-09 |
| 基金项目:福建省自然科学基金项目（2017J01289），福建卫健委医学创新课题(2017-CX-32)，福建卫健委中青年骨干培养计划（2017-ZQN-50）。 |
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| Application of articular ultrasound in the differential diagnosis of seronegative rheumatoid arthritis and osteoarthritis |
| Huangyinan,Chenshuqiang,Ruanqinyun,Liuxinxiu,Chenling,Chenjunmin,Zhuangyong |
| () |
| Abstract: |
| Objective:Research value of articular ultrasound in the differential diagnosis of serological negative rheumatoid arthritis and osteoarthritis. Methods:145 cases of OA and SNRA with the main complaint of knee, elbow, wrist or proximal interphalangeal joint pain were included and examined by routine doppler ultrasonography, focusing on bone erosion, synovial thickening, and synovial blood flow signal evaluation. Diagnosis was made according to ACR/EULAR criteria after 6 months follow-up. The main differences of ultrasonic features between SNRA and OA groups were compared. Results:A total of 145 patients and 425 joints were examined in this study. 75 patients with 194 joints were in the OA group and 70 patients with in the SNRA group. In aspect of SNRA diagnosis,2-3 grade degree bone erosion has the specificity of 93.33 and the sensitivity of 41.82%. In 0-1 degree bone erosion cases, the degree of synovial thickening and the difference of synovial blood flow signal were significantly different between SNRA and OA groups (p<0.01). Conclusion:Ultrasound play important role in identifying SNRA and OA in bone erosion and synovitis evaluation. |
| Key words: serological negative,rheumatoid arthritis ultrasound bone erosion |
