Xue Qin, Zhu Jia-an, Wang Nian-song, Zhang Xiao-guang, Gao Xu-ping, Wang Feng, Fan Ying, Yu Gang
Department of Nephrology & Rheumatology, Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.
Zhonghua Yi Xue Za Zhi. 2010 Jul 20;90(27):1897-901.
To explore the value of color Doppler ultrasound in evaluating the therapeutic effects on ankylosing spondylitis (AS) patients.
Color Doppler high-frequency ultrasound images and blood flow in 30 healthy volunteers and 50 AS patients, changes of high-frequency ultrasound images and blood flow of involved sites in AS patients pre- and after-Etanercept treatments, as well as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and the Bath AS disease activity indices pre- and post-treatment were compared.
Positive rates were significantly different between healthy volunteers and AS patients in terms of sacroiliac joints, Achilles tendon attachments, patellar ligament attachments, and rectus femoris tendon attachments by ultrasonograph (P < 0.05); and the fibular collateral ligament attachments positive rates had no significant difference with those at pre-treatment (P > 0.05). There was significant difference between patients with Bath AS disease activity index (BASDAI) ≥ 4 and those with BASDAI < 4 with respects to peripheral enthesis positive rate, Bath AS functional index (BASFI), patient's global assessment VAS (PGA), nocturnal back pain and general back pain VAS, morning stiffness duration, ESR and CRP (P < 0.05). Positive rates of sacroiliac joints, Achilles tendon attachments, patellar ligament attachments and rectus femoris tendon by ultrasonograph significantly decreased at Weeks 12 and 24 at post-treatment compared to that at pre-treatment (P < 0.05); there was significant difference for patient's BASDAI, BASFI, ESR and CRP at pre-treatment and weeks 12 and 24 post-treatment (P < 0.05).
Ultrasound can sensitively detect the pathological changes of joint synovium and entheses so that it may be used as a routine method of monitoring diseases in these soft tissues, following up AS patients and evaluating clinical efficacy.
探讨彩色多普勒超声在评估强直性脊柱炎（AS）患者治疗效果中的价值。
比较30例健康志愿者和50例AS患者的彩色多普勒高频超声图像及血流情况，AS患者在使用依那西普治疗前后受累部位高频超声图像及血流的变化，以及治疗前后的红细胞沉降率（ESR）、C反应蛋白（CRP）和巴斯强直性脊柱炎疾病活动指数。
超声检查显示，健康志愿者与AS患者在骶髂关节、跟腱附着点、髌韧带附着点和股直肌肌腱附着点的阳性率存在显著差异（P<0.05）；腓侧副韧带附着点的阳性率与治疗前相比无显著差异（P>0.05）。巴斯强直性脊柱炎疾病活动指数（BASDAI）≥4的患者与BASDAI<4的患者在外周附着点阳性率、巴斯强直性脊柱炎功能指数（BASFI）、患者整体评估视觉模拟评分（PGA）、夜间背痛和一般背痛视觉模拟评分、晨僵持续时间、ESR和CRP方面存在显著差异（P<0.05）。与治疗前相比，治疗后第12周和第24周超声检查显示骶髂关节、跟腱附着点、髌韧带附着点和股直肌肌腱的阳性率显著降低（P<0.05）；治疗前与治疗后第12周和第24周患者的BASDAI、BASFI、ESR和CRP存在显著差异（P<0.05）。
超声能够敏感地检测关节滑膜和附着点的病理变化，可作为监测这些软组织疾病、随访AS患者及评估临床疗效的常规方法。
