Department of Rheumatology, Diakonhjemmet Hospital, Box 23, Vinderen, N-0319 Oslo, Norway.
Ann Rheum Dis. 2010 Jul;69(7):1349-51. doi: 10.1136/ard.2009.126995. Epub 2010 May 14.
To examine associations between ultrasonography (US) assessments (B-mode (BM) and power Doppler (PD)) of a large number of joints and traditional assessments of disease activity, and to examine the sensitivity to change of the US scores and clinical measures in patients with rheumatoid arthritis (RA).
Twenty patients with RA initiating adalimumab treatment were examined at baseline and after 1, 3, 6 and 12 months with US (BM and PD) using an Outcome Measures in Rheumatoid Arthritis Clinical Trial semiquantitative scoring (0-3) of 78 joints as well as assessment of clinical and laboratory variables with calculation of composite indexes.
The US scores were associated with composite scores as well as clinical and laboratory variables (r=0.41-0.84, p<0.05-0.001 at 12-months' follow-up). Compared with clinical assessments, US detected higher numbers of inflamed joints. The US scores decreased after 1 and 3 months (p<0.005) and PD showed the highest percentage improvement. Both BM and PD had high standardised response means throughout the study (-0.83 to -1.27), of similar magnitude to composite indexes, but higher than the clinical and laboratory variables.
The comprehensive US assessments were associated with clinical and laboratory variables of disease activity and were highly sensitive to change during treatment with biological agents.
探讨大量关节的超声（B 型（BM）和能量多普勒（PD））评估与传统疾病活动评估之间的关联，并探讨超声评分和类风湿关节炎（RA）患者临床指标的变化敏感性。
20 例接受阿达木单抗治疗的 RA 患者在基线时以及治疗后 1、3、6 和 12 个月时，采用 Outcome Measures in Rheumatoid Arthritis Clinical Trial 半定量评分（0-3）对 78 个关节进行超声（BM 和 PD）检查，同时评估临床和实验室变量，并计算综合指数。
超声评分与综合评分以及临床和实验室变量相关（r=0.41-0.84，p<0.05-0.001 在 12 个月的随访时）。与临床评估相比，超声检测到更多的炎症关节。超声评分在 1 个月和 3 个月后下降（p<0.005），PD 显示出最高的改善百分比。在整个研究过程中，BM 和 PD 的标准化反应均值均较高（-0.83 至-1.27），与综合指数相似，但高于临床和实验室变量。
综合超声评估与疾病活动的临床和实验室变量相关，并且在生物制剂治疗期间对变化非常敏感。
