临床检查方法与超声技术诊断类风湿关节炎关节滑膜炎的对比研究

目的 比较临床方法与超声技术诊断类风湿关节炎（RA）患者关节滑膜炎的一致性并分析其相关性.方法 选取200例RA患者,分别对其28个关节进行临床及超声检查,实验室检查包括血沉和C反应蛋白.结果 临床检查发现330个关节（5.9%）有滑膜炎,超声检查发现537个关节（9.6%）有滑膜炎.超声指标与肿胀关节数有相关性,但与疼痛/压痛关节数及活动受限关节数无相关性.另外发现PD信号分级与CRP、DAS28评分正相关.结论 超声可以发现无临床症状的滑膜炎,在临床和实验室检查的基础上结合超声检查才能更准确评价RA患者,从而为病情活动性评估、治疗方案的选择、疗效的评估提供重要依据.

Comparison of clinical with ultrasound determined synovitis in rheuma-toid arthritis

Objective To compare clinical evaluation and uhrasonography （US） in the assessment of joint synovitis in rheumatoid arthritis. Methods Two hundred patients underwent clinical evaluation, ultrasonography and Laboratory assessment. Results A total of 330（5.9%） and 537 （9.6%） joints had clinical and US synovitis, respectively. US vari- ables were correlated with clinical measures of joint swelling, but poorly correlated with those of joint tenderness/pain and restricted motion. PD signal were correlated with CRP and DAS28. Conclusion US can detected subclinical syn- ovitis in rheumatoid arthritis. This finding may have important implications for disease activity and may affect the choice of the optimal therapeutic strategy and mearsure the response to therapy in patients with rheumatoid arthritis.