超声检查对类风湿关节炎膝关节活动期病变的诊断价值

目的探讨超声在不同病程类风湿性关节炎（RA）患者膝关节活动期病变的诊断价值。方法53例RA患者分为RA早期组（病程≤2年）和RA晚期组（病程〉2年），25例体检健康者为对照组；观察各组膝关节超声表现，比较髌上囊积液深度、髌上囊及膝内外侧区滑膜厚度及滑膜内血流情况。结果对照组、RA早期组、RA晚期组的内外侧滑膜厚度、髌上囊滑膜及髌上囊积液深度依次增大，组间比较差异均有统计学意义（P〈0．001）；同时RA晚期组较RA早期组骨质破坏更明显，但血流信号分级差异无统计学意义。结论超声可显示不同病程的RA活动期膝关节病变，对指导临床诊疗有重要意义。

Diagnostic value of ultrasonography in active stage of rheumatoid arthritis knee with different course

Objective To explore the diagnostic value of ultrasonography in active stage of rheumatoid arthritis （RA） knee with different course. Methods Fifty-three patients with RA were divide into the early group（course 〈 2 years）and the late group （course 〉 2 years）. The control group was composed by 25 health examinationers. Ultrasonic appearance of knee in all groups was observed using high-frequency ultrasound. The depth of suprapatellar bursa hydrops,synovium thickness of suprapatellar bursa and internal and external region of knee and blood flow within synovium were compared. Results Internal and external synovium thickness, synovium thickness of suprapatellar bursa and the depth of suprapatellar bursa hydrops in the control group, the early RA group and the late RA group decreased in turn. There were significant differences among the groups（P 〈 0.001 ）. Bone destruction of joints in the late RA group was more obvious than that in the early RA group. However, there was no significant differcece in blood flow signal grades between the two groups. Conclusion Ultrasound can display various lesions of RA knee in different course to guide the clinical diagnosis and treatment.