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原发性干燥综合征关节炎患者的肌骨超声评估及免疫生化特征分析 |
曹雨,乔晓光,于海峰,李少刚,张宝玲 |
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(北京市朝阳区双桥医院骨科;重庆市巴南区人民医院超声科) |
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摘要: |
目的:探索肌骨超声评估原发性干燥综合征(PSS)关节炎作用性以及患者免疫生化特征。方法:81例PSS患者在2019年4月至2020年4月期间收治,均进行肌骨超声、免疫生化检测,分析肌骨超声准确率、特异性、敏感性,并根据确诊结果,将PSS患者分为关节炎组(n=65),非关节炎组(n=16),对比两组各项超声检查结果、免疫生化指标、年龄。结果:81例PSS患者,经后期确诊为关节炎的有65例,患病率为80.25%(65/81)。经肌骨超声检查,准确率为96.30%,敏感性为96.92%,特异性为93.75,AUC为0.953,具有较高预测准确性。同时关节炎组患者骨侵蚀、骨赘、肌腱腱鞘炎、关节间隙狭窄、滑膜炎、关节积液率以及血流信号评分高于非关节炎者(P<0.05),滑膜厚度厚于非关节炎者(P<0.05)。从免疫生化指标角度分析,两组对比IgA、IgM指标无统计差异性(P>0.05),而关节炎组年龄、RF、IgG、ESR、CRP高于非关节炎组(P<0.05);PSS关节炎患病率与年龄、RF、IgG、ESR、CRP、滑膜厚度、血流信号、SSDAI评分呈负相关性,与骨侵蚀、骨赘、肌腱腱鞘炎、关节间隙狭窄、滑膜炎、关节积液呈正相关性。结论:肌骨超声在PSS关节评判中具有较高特异性和敏感性,配合免疫生化检测,发现PSS关节炎患者存在高免疫炎性反应和高球蛋白血症,表现为RF、IgG、ESR、CRP指标升高。 |
关键词: 原发性干燥综合征关节炎 肌骨超声 免疫生化 特征 |
DOI: |
投稿时间:2020-11-20修订日期:2020-12-21 |
基金项目: |
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Musculoskeletal ultrasound assessment and immunobiochemical characteristics analysis of patients with primary Sjogren’s syndrome arthritis |
Cao Yu,Qiao Xiaoguang,Yu Haifeng,Li Shaogang,Zhang Baoling |
(Ultrasonography Department of People''''s Hospital of Chongqing Banan District) |
Abstract: |
: Objective: Explore musculoskeletal ultrasound to evaluate the effects of primary Sjogren’s syndrome (PSS) arthritis and the immune biochemical characteristics of patients. Methods: All 81 patients with PSS were admitted between April 2019 and April 2020. Musculoskeletal ultrasound and immuno-biochemical tests were performed to analyze the accuracy, specificity, and sensitivity of musculoskeletal ultrasound. According to the diagnosis results, PSS patients were classified Divided into arthritis group (n=65) and non-arthritis group (n=16). The ultrasound examination results, immunobiochemical indexes, and age of the two groups were compared. Results: Among the 81 patients with PSS, 65 were diagnosed with arthritis at a later stage, and the prevalence was 80.25% (65/81). The accuracy of musculoskeletal ultrasound examination was 96.30%, the sensitivity was 96.92%, the specificity was 93.75, and the AUC was 0.953, which has high predictive accuracy. In the arthritis group, bone erosion, osteophytes, tendon tenosynovitis, joint space stenosis, synovitis, joint effusion rate and blood flow signal score were higher than those of non-arthritis patients (P<0.05), and the thickness of synovial membrane was thicker than that of non-arthritis Those with inflammation (P<0.05). From the perspective of immunobiochemical indicators, there is no statistical difference between the two groups in IgA and IgM indicators (P>0.05), while the age, RF, IgG, ESR, and CRP of the arthritis group are higher than those of the non-arthritis group (P<0.05); The prevalence of PSS arthritis is negatively correlated with age, RF, IgG, ESR, CRP, synovial thickness, blood flow signal, SSDAI score, and is associated with bone erosion, osteophytes, tendon tenosynovitis, joint space stenosis, synovitis, There is a positive correlation with joint effusion. Conclusion: Musculoskeletal ultrasound has high specificity and sensitivity in the assessment of PSS joints. In conjunction with immuno-biochemical testing, it is found that patients with PSS arthritis have hyperimmune inflammation and hyperglobulinemia, which are manifested as RF, IgG, ESR, CRP index increased. |
Key words: : primary Sjogren’s syndrome arthritis musculoskeletal ultrasound immunobiochemistry characteristics |
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