急性痛风性关节炎的超声特征分析
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摘要
目的:分析急性痛风患者受累关节的声像图表现。方法:选取临床确诊的168例急性发作痛风性关节炎患者,其中有56例为首次急性发作,112例为间歇期急性发作。对所有患者的双跖趾关节,双踝、双膝、双掌指关节、双腕及双肘关节进行超声检查,总结并分析两组间超声下痛风石、双轨征、高回声聚集体、骨侵蚀、滑膜增生及积液的发生率及差异,采用χ2检验进行统计学分析。结果:急性痛风患者中可发现各种超声阳性改变,首次急性发作期患者中,关节腔积液发生率最高,痛风石发生率最低。间歇期急性发作患者中,滑膜增生发生率最高,骨侵蚀发生率最低。两组中发作部位均为MTP1关节最多见,其次为踝关节,上肢关节发生率均较低。结论:急性痛风患者受累关节以积液及滑膜增生表现最为显著。双轨征、痛风石及骨侵蚀的发生率与患者的发作次数及病程有正相关性。
引文
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[8]Peiteado D, Villalba A, De Miguel E, et al. Longitudinal study of ultrasonography sensibility to change in patients with gout after one year of treatment[J]. Ann Rheum Dis, 2010, 69(Suppl 3):713.
[9]Peiteado D, De Miguel E, Villalba A, et al. Value of a short four joint ultrasound test for gout diagnosis:a polot study[J]. Clin Exp Rheumatol, 2012, 30(6):830-837.
[2]朱儒焱.痛风性关节炎误诊16例原因分析[J].现代医药卫生,2015,31(9):1374-1376.
[3]唐小兰,唐远娇,向茜,等.高频超声对痛风性关节炎的诊断效能及与其他影像学检查的对比研究[J].中华医学超声杂志:电子版,2016,13(4):249-253.
[4]Neogi T, Jansen TL, Dalbeth N, et al. 2015 Gout classification criteria:an American College Rheumatology/Eurppean League Against Rheumatism collaborative initiative[J]. Ann Rheum Dis,2015, 74(10):1789-1798.
[5]Gutierrez M, Schmidt WA, Thiele RG, et al. OMERACT Ultrasound Gout Task Force group. International Consensus for ultrasound lesions in gout:results of Delphi process and web-reliability exercise[J]. Rheumatology(Oxford), 2015, 54(10):1797-1805.
[6]Schlesinger N, Thiele RG. The pathogenesis of bone erosions in gouty arthritis[J]. Ann Rheum Dis, 2010, 69(6):1907-1912.
[7]邓雪蓉,耿研,张卓莉.不同时期痛风性关节炎的超声特征比较[J].中华风湿病学杂志,2016,20(1):23-27.
[8]Peiteado D, Villalba A, De Miguel E, et al. Longitudinal study of ultrasonography sensibility to change in patients with gout after one year of treatment[J]. Ann Rheum Dis, 2010, 69(Suppl 3):713.
[9]Peiteado D, De Miguel E, Villalba A, et al. Value of a short four joint ultrasound test for gout diagnosis:a polot study[J]. Clin Exp Rheumatol, 2012, 30(6):830-837.