能量多普勒评价类风湿关节炎疾病活动度的价值

 目的 通过与DAS28比较,探讨能量多普勒评价类风湿关节炎(rheumatoid arthritis ,RA) 疾病活动度的价值。方法 选择RA患者74例,记录膝关节的能量多普勒信号,并记录28个关节的肿胀数、压痛数、血沉(erythrocyte sedimentation,ESR)、C-反应蛋白(CRP)及患者基于100 mm视觉模拟尺(VAS),对疾病活动度进行评价,计算DAS28评分。专业超声医师对患者肿胀膝关节进行能量多普勒检查,PD评分分为4级后与DAS28评分做Kappa检验。结果 74例中,1例(1%)无血流信号,2例(3%)少量点状信号,32例(43%)大量短条状血流信号,39例(53%)树枝状信号。将DAS28-CRP及DAS28-ESR分组后与能量多普勒信号分别比较发现,能量多普勒与DAS28一致性好(DAS28-ESR κ=0.701,P<0.05;DAS28-CRP κ=0.777,P<0.05)。结论 能量多普勒能够评价RA关节炎的疾病活动度。

Value of power Doppler in evaluating the activity of rheumatoid arthritis

Objective To compare the correlations between power Doppler and Disease Activity Score with 28 joints (DAS28) by estimating the value of the activity of rheumatoid arthritis (RA).Methods Seventy-four cases of RA patients were selected. The power Doppler signals of knee joints were recorded. The number of cases of swelling of 28 joints, the number of cases of tenderness of the 28 joints, erythrocyte sedimentation(ESR) and C-reactive protein(CRP) were recorded. The patients were evaluated according to the 100mm visual analogue scale (VAS) in order to calculate the DAS28 score. According to the intensity of signals, the ultrasound doctor performed a power Doppler examination on the swollen knees of the patients and divided them into four groups.Results A total of seventy-four patients with RA were enrolled, including one knee (1%) without blood flow signals, two patients (3%)with a small number of punctate signals, thirty-two cases (43%) with a large number of short-striped blood flow signals and thirty-nine cases (44%) with dendritic signals. A comparison with signals of power Doppler revealed that power Doppler well conformed to DAS28 (DAS28-ESR κ=0.701,P<0.05;DAS28-CRPκ=0.777,P<0.05).Conclusions The disease activity of RA can be evaluated with power Doppler.