膝关节类风湿性关节炎和骨关节炎软骨损伤的MRI比较研究

目的探讨磁共振成像(MRI)在区分诊断膝关节类风湿性关节炎与骨关节炎患者中的比较研究。方法选取2017年7月-2019年7月收治的57例膝关节类风湿性关节炎(RA)患者和63例骨关节炎(OA)患者作为研究对象,均进行进行MRI检查。比较分析其检查结果。结果 RA患者内侧胫骨关节(股骨内踝、胫骨内侧平台)、外侧胫骨关节(股骨外踝、胫骨外侧平台)软骨损伤分级差异无统计学意义(P0.05); OA患者内侧胫骨关节(股骨内踝、胫骨内侧平台)的软骨损伤分级显著高于外侧胫骨关节(股骨外踝、胫骨外侧平台),差异有统计学意义(P0.05)。结论 MRI在区分诊断RA和OA患者中具有较高的应用价值。     

类风湿性关节炎腕关节骨侵蚀改变影像学分析（30例报告）

对30例类风湿性关节炎患者腕关节骨侵蚀的x线平片和CT及MRI对照研究，结果表明MRI及CT对早期发现类风湿性关节炎骨侵蚀的敏感性优于x线片有助于早期诊断。     

探讨X线平片、CT和MRI在检查类风湿性关节炎患者早期腕关节病变中的作用

目的 探讨X线平片、CT和MRI在检查类风湿性关节炎(RA)患者早期腕关节病变中的作用.方法 将我院2010年--2012年收治的26例RA患者作为研究对象,为了比较观察X线平片、CT及MRI在RA早期腕关节病变中的作用,分别对病患左、右腕行CT与MRI冠状面扫描,对扫描结果进行两两比较.结果 26例RA患者共计52个腕关节,但X线、CT及MRI三种不同方式的检出结果及检出率之间有着明显的差异(P<0.05),具有统计学意义.结论 对于RA患者行早期腕关节病变检查时,行MRI与CT检查效果明显要优于X线检查,若对于传统X线检查所示不足为诊断RA患者提供证据时,可进一步行CT或者MRI检查.     

肌骨超声与X线片对类风湿性关节炎腕关节早期病变诊断的价值对比

目的对比肌骨超声与X线片对诊断类风湿性关节炎(RA)腕关节早期病变的价值。方法将2017年1月至2019年1月期间我院收治的40例RA患者设为观察组,并选取同期我院40例健康体检者作为对照组。两组研究对象均进行彩色超声诊断检查,对比其腕关节滑膜厚度;同时观察组应用X线片进行检查,对比肌骨超声和X线片检查RA患者腕关节早期病变的情况。结果观察组的腕关节平均滑膜厚度高于对照组(P<0.05)。肌骨超声对RA患者腕关节早期病变检出率高于X线片(P<0.05)。结论采用肌骨超声诊断RA腕关节早期病变的效果更明显,检出率更高,为RA患者早期诊断和治疗提供基础。     

类风湿性关节炎临床路径

文章对类风湿性关节炎临床路径进行介绍.     

老年类风湿性关节炎值得关注

<正> 类风湿性关节炎是一种累及滑膜的慢性炎性疾病,可伴有发热、不适、疲劳及体重下降等全身表现,目前病因尚不明确。它常发生于30～50岁左右的人群,女性发病率约为男性的2～3倍,并且随年龄增长而上升。 不同于年轻人的是,60岁以后发病的类风湿性关节炎病人常仅有轻度关节炎,无明显类风湿结节,大多数病人逐步形成对称性疼痛、肿胀、外周关节僵硬而累及末梢指趾关节,大关节如肩关节常被累及。另外,60岁以后发病的类风湿性关节炎病     

免疫指标检测分析在类风湿性关节炎诊断中的意义

目的探讨免疫指标检测分析在类风湿性关节炎诊断中的意义。方法采用免疫散射比浊法检测血清免疫球蛋白(IgG、IgA、IgM),补体C3、C4水平,RA患者治疗前后比较,RA患者与健康者比较。结果 RA活动期患者IgG、IgA、IgM水平较健康者水平明显增高,差异具有显著性(p<0.05);RA活动期患者C3、C4水平较健康者水平低,但无显著性差异(p>0.05);RA患者治疗前后比较各项检测的免疫指标均无显著变化。结论 RA患者体内存在多种免疫功能的紊乱,检测免疫指标对疾病的诊断、治疗和预后有重要的意义。     

类风湿性腕关节炎的MRI表现及临床对比应用研究探索

目的:研究探索类风湿性腕关节炎的MRI表现及临床对比应用.方法在本院2016年6月—2017年6月间接诊的类风湿性腕关节炎患者中随机选取100例作为本次研究的对象,行双腕MRI检查X线平片检查,对检查结果进行对比应用分析.结果血管翳、骨质破坏、骨髓水肿及关节积液的检出灵敏度分别为100.00%、80.00%、73.33%和83.33%.结论MRI检查能够清晰、明确的显示类风湿性腕关节炎的病理变化情况,为临床诊治提供可靠依据,在临床对比应用中具有相对较高的价值.     

类风湿性关节炎的护理

类风湿性关节炎是以关节及关节周围组织的慢性炎症为主,同时又可侵犯身体其他部位的疾病。以病情况加重和缓解交替进行为特点,致残率极高。现将我们护理类风湿性关节炎的病人的体会介绍如下:1 护理人员必须明确类风湿性关节炎患者住院的目的。此病     

类风湿关节炎药物治疗后的护理思路及方法

目的 研究类风湿关节炎护理指导对患者临床症状的改善、关节功能提高等方面的作用。方法通过给予患者心理护理,针对药物副作用进行护理,并在饮食、关节功能锻炼方面给予适当的护理。结果护理干预后,患者的临床症状和实验室指标有不同程度的改善,3个月、6个月后评价疗效,总有效率分别为79．2％和91．7％,两者比较,差异有统计学意义（P〈0．05）。观察期间未发生严重的不良反应。结论护理指导能在一定程度上减轻患者症状,改善关节功能,促进其康复。     

类风湿关节炎药物治疗后的护理思路及方法

目的研究类风湿关节炎护理指导对患者临床症状的改善、关节功能提高等方面的作用。方法通过给予患者心理护理,针对药物副作用进行护理,并在饮食、关节功能锻炼方面给予适当的护理。结果护理干预后,患者的临床症状和实验室指标有不同程度的改善,3个月、6个月后评价疗效,总有效率分别为79.2%和91.7%,两者比较,差异有统计学意义(P<0.05)。观察期间未发生严重的不良反应。结论护理指导能在一定程度上减轻患者症状,改善关节功能,促进其康复。     

两种非甾体抗炎药物方案治疗类风湿关节炎的成本--效用分析

目的 :评价两种非甾体抗炎药物的疗效和经济性 ,探索成本 -效用分析方法的应用。方法 :对 1 0 6例类风湿关节炎 (RA)患者随机分两组 (A:奥湿克组 ,B:扶他林组 ) ,使用自编 RA生命质量量表对患者进行评价 ,提取评分法效用值 ,进行成本效用分析 (cost- utility analysis,CUA)。结果 :B组的成本效用比 (CUR)为 52 92 7.0 8元 / QALY,A组的 CUR值 67838.30元 / QALY,敏感度分析得到一致结果 ,增量成本效用分析表明每增加 1 QALY,A组至少需追加花费1 9980 5.1 4元 ,故认为 B方案经济、有效。结论 :对于 RA、癌症等慢性病患者采用 CUA分析 ,能够全面评价患者生命质量 ,保证卫生资源的合理利用     

The Direct Cost of Rheumatoid Arthritis

OBJECTIVES: This analysis estimated the direct cost of rheumatoid arthritis (RA) from a societal perspective. METHODS: Primary and secondary data sets were used to determine the rate of medical resource utilization. National average Medicare or Medicaid reimbursement rates were used to value direct costs (in 1994 dollars). RESULTS: Persons with RA have, on average, dollar 1702 in direct costs for treating RA annually. More than half of the total cost is for medications. Nursing home care accounts for nearly one fifth of the cost and hospitalizations and ambulatory care (combined) comprise another fifth of the total cost. Travel to medical appointments and medical supplies make up the remaining 10%. The projected annual US direct costs are dollar 3.6 billion for treating RA. CONCLUSIONS: The health care utilization in persons with RA is frequent and includes a number of components leading to high annual direct cost.     

Evaluation of Gluten Exclusion for the Improvement of Rheumatoid Arthritis in Adults

There is currently a growing anti-gluten trend which, except for individuals with coeliac disease and non-coeliac gluten sensitivity (NCGS) for whom its intake is contraindicated, results in gluten (the main protein in wheat and other cereals) being considered harmful to health and excluded from diets, largely due to information distributed through social networks. However, in many cases the recommendation to exclude gluten from the diet goes beyond personal choice and is promoted by health professionals. This choice and/or recommendation is especially important to individuals with chronic inflammatory diseases such as rheumatoid arthritis (RA), for which this exclusion is justified to reduce the symptoms of the disease. The aim of this literature review is to assess whether there is scientific evidence to justify the elimination of gluten in patients with RA, neither coeliac nor with NCGS, to improve their symptoms and quality of life. The results of the search on gluten and RA carried out in the Embase database and the extraction of data from 16 articles included in the review are presented. No scientific evidence was found to recommend the exclusion of gluten in patients with RA.     

Nutrition and Rheumatoid Arthritis Onset: A Prospective Analysis Using the UK Biobank

Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects the joints. The multifactorial etiopathogenesis of RA has been heavily investigated, but is still only partially understood. Diet can represent both a risk factor and a protective factor, based on some evidence that suggests specific properties of certain foods and their ability to increase/reduce inflammation. To date, the studies done on this topic provide discordant results and are heterogeneous in terms of design and cohort size. In this work, we investigated for the first time the relationship between nutrition and the risk of RA onset using a sample size of about half a million subjects from one of the largest publicly available biobanks that is the UK biobank. Results showed that oily fish, alcohol, coffee and breakfast cereals have protective roles in RA; whereas, tea can increase the risk of RA. In conclusion, the obtained results confirm that diet plays key roles in RA, either by promoting or by preventing RA onset and development. Future research should focus on unravelling the effects of dietary habits on immune-mediated diseases to establish better preventive strategies.     

类风湿性关节炎患者护理管理效果评价

目的：对类风湿性关节炎（ RA）患者实施以家庭为单位的综合干预,强化治疗效果,探讨以家庭为单位RA护理管理模式。方法将本院103例RA患者随机分为试验组52例、对照组51例。对试验组的患者采用以家庭为单位自我管理护理模式进行干预,对照组的患者采用常规护理管理模式,比较两组患者干预效果。结果试验组患者对疾病相关知识的知晓率高于对照组（94．23％／66．67％）,差异显著（P＜0．05）;干预后,除压力管理和人际关系外,试验组健康行为总分及其余各维度得分均高于对照组,差异显著（P＜0．05）;干预后,试验组的家庭功能总分及除情感反应和情感介入外的其余5个维度得分均高于对照组（ P＜0．05）。结论 RA患者采用以家庭为单位的护理模式是改善患者家庭功能及生存质量的有效方法。     

Diet as a Modulator of Intestinal Microbiota in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic immune-driven inflammatory disease characterised by synovial inflammation, leading to progressive cartilage and bone destruction, impacting patients’ functional capacity and quality of life. Patients with RA have significant differences in gut microbiota composition when compared to controls. Intestinal dysbiosis influences the intestinal barrier strength, integrity and function, and diet is considered the main environmental factor impacting gut microbiota. Over the last few years, researchers have focused on the influence of single components of the diet in the modulation of intestinal microbiota in RA rather than whole dietary patterns. In this review, we focus on how the Mediterranean diet (MD), a whole dietary pattern, could possibly act as an adjuvant therapeutic approach, modulating intestinal microbiota and intestinal barrier function in order to improve RA-related outcomes. We also review the potential effects of particular components of the MD, such as n-3 polyunsaturated fatty acids (PUFAs), polyphenols and fibre.     

Genetic Variants Influencing Joint Damage in Mexican Americans and European Americans With Rheumatoid Arthritis

Joint destruction in rheumatoid arthritis (RA) is heritable, but knowledge on specific genetic determinants of joint damage in RA is limited. We have used the Immunochip array to examine whether genetic variants influence variation in joint damage in a cohort of Mexican Americans (MA) and European Americans (EA) with RA. We studied 720 MA and 424 EA patients with RA. Joint damage was quantified using a radiograph of both hands and wrists, scored using Sharp's technique. We conducted association analyses with the transformed Sharp score and the Immunochip single nucleotide polymorphism (SNP) data using PLINK. In MAs, 15 SNPs from chromosomes 1, 5, 9, 17 and 22 associated with joint damage yielded strong p‐values (p < 1 × 10^?4). The strongest association with joint damage was observed with rs7216796, an intronic SNP located in the MAP3K14 gene, on chromosome 17 (β ± SE = ?0.25 ± 0.05, p = 6.23 × 10^?6). In EAs, 28 SNPs from chromosomes 1, 4, 6, 9, and 21 showed associations with joint damage (p‐value < 1 × 10^?4). The best association was observed on chromosome 9 with rs59902911 (β ± SE = 0.86 ± 0.17, p = 1.01 × 10^?6), a synonymous SNP within the CARD9 gene. We also observed suggestive evidence for some loci influencing joint damage in MAs and EAs. We identified two novel independent loci (MAP3K14 and CARD9) strongly associated with joint damage in MAs and EAs and a few shared loci showing suggestive evidence for association.     

MRI对骶骨肿瘤的诊断价值

目的:分析MRI对骶骨肿瘤的诊断价值。方法:回顾分析26例骶骨肿瘤的影像学表现,经手术、活检病理或随访证实,其中脊索瘤11例,软骨肉瘤1例,骨巨细胞瘤3例,转移瘤8例,神经源性3例。所有病理经X线及MRI检查,部分行多排螺旋CT(MDCT)检查。结果:各种骶骨肿瘤包括不同的肿瘤范围和不同的肿瘤中心,不同的破坏程度,不同的MRI信号强度及软组织肿块,不同的钙化灶及不同程度的骨髓浸润。结论:MRI对骶骨肿瘤的诊断有重要的价值,尤其是对病变的范围的确定,对临床选择治疗方式具有重要的价值。