银屑病甲损害与超声下远端指间关节改变的相关性分析

目的:分析银屑病患者甲损害与超声下远端指间关节改变的相关性。方法:纳入中重度寻常型银屑病(PsO)患者和关节病型银屑病(PsA)患者，记录患者的基本临床资料、甲损害特点以及超声下甲单元及远端指间关节情况。结果:研究共纳入中重度PsO患者38例，PsA患者35例。PsA组甲损害发生率高于中重度PsO组(85.7%vs 63.2%,P=0.028),前者mNAPSI评分(P=0.042)及甲板厚度(P<0.001)也高于后者。与中重度PsO组相比，PsA组附着点炎及骨赘形成的检出率高(77.1%vs 28.9%,P<0.001;74.3%vs 31.6%,P<0.001)。在中重度PsO患者的手指中，甲损害组指伸肌腱附着点炎及关节积液的发生率高于无甲损害组(11.4%vs 2.6%,P<0.001;35.6%vs 12.6%,P<0.001),在PsA患者的手指中，甲损害组指伸肌腱附着点炎、关节积液、滑膜炎、骨侵蚀、骨赘形成的发生率均高于无甲损害组(均P<0.05);所有患者同一手指水平mNAPSI评分、甲剥离、甲凹点均与指伸肌腱附着点炎相关，相关性最显...

Analysis of correlation between psoriatic nail involvement and changes of the distal interphalangeal joint under ultrasound

Objective: To analyze the correlation between nail involvement and ultrasound changes in the distal interphalangeal joint in patients with psoriasis. Methods: Patients with moderate to severe psoriasis vulgaris (PsO) and psoriatic arthritis (PsA) were enrolled, and their basic clinical data, characteristics of nail damage, nail unit and distal interphalangeal joint changes under ultrasound were recorded. Results: A total of 38 patients with moderate to severe PsO and 35 patients with PsA were included. The incidence of nail changes in PsA group was higher than that in moderate to severe PsO group (85.7% vs 63.2%, P=0.028), mNAPSI score in PsA group (P=0.042) and deck thickness (P<0.001) were also higher than that in PsO group. Compared with moderate to severe PsO group, PsA group had a higher detection rate of enthesopathy and osteophyte formation (77.1% vs 28.9%, P<0.001; 74.3% vs 31.6%, P<0.001). In the fingers of patients with moderate to severe PsO, the incidence of extensor tendon enthesopathy and joint effusion was higher in the nail involvement group than in the fingers without nail involvement group (11.4% vs 2.6%, P<0.001;35.6% vs 12.6%, P<0.001). The incidence of finger extensor tendon enthesopathy, joint effusion, synovitis, bone erosion and osteophyte formation in PsA patients with nail involvement group was higher than that without nail involvement group (Ps<0.05). On the same finger, the mNAPSI score, onycholysis and pitting were related to extensor tendon enthesopathy in all patients, especially the pitting with strong correlation. (OR 2.02; 95%CI 1.13-3.60). Conclusion: Patients with PsA are more prone to nail involvement and enthesopathy at distal interphalangeal joint. The occurrence of extensor tendon enthesopathy is significantly related to mNAPSI score, onycholysis and pitting.