与临床受累关节相对应的滑膜分级和一种可行的超声调整后简单疾病活动指数，用于监测类风湿关节炎。

The synovial grade corresponding to clinically involved joints and a feasible ultrasound-adjusted simple disease activity index for monitoring rheumatoid arthritis.

机构信息

a Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine , Tokyo , Japan.

出版信息

Mod Rheumatol. 2016 Nov;26(6):844-849. doi: 10.3109/14397595.2016.1158385. Epub 2016 Apr 26.

DOI:10.3109/14397595.2016.1158385

PMID:26913787

Abstract

OBJECTIVES

To determine which grade of ultrasound (US) synovitis corresponds to clinically involved joints in rheumatoid arthritis (RA) and develops a new US-adjusted composite measure.

METHODS

Clinical and US examinations were performed on 137 patients with RA (28 joints). Synovial effusion, hypertrophy, and blood flow were semiquantitatively graded from 0 to 3 using gray scale (GS) and power Doppler (PD) modes. We calculated US-adjusted simple disease activity index (SDAI) and assessed feasibility, and external validity by comparing with erythrocyte sedimentation rate (ESR), and modified health assessment questionnaires (MHAQ).

RESULTS

GS ≥2 and PD ≥0 corresponds to clinically swollen joints, and GS ≥2 and PD ≥1 corresponds to tender joints. The US-adjusted SDAI showed the highest correlation when US-determined swollen joints were defined as PD ≥2 with ESR, and GS ≥3 and PD ≥2 with MHAQ. A feasible US-adjusted SDAI examining only clinically involved joints still showed a higher correlation with ESR and MHAQ than SDAI.

CONCLUSION

Our composite measure complemented by US only for clinically involved joints is feasible and reliable for monitoring disease activity.

摘要

目的

确定何种超声（US）滑膜炎分级与类风湿关节炎（RA）的临床受累关节相对应，并制定新的 US 调整综合指标。

方法

对 137 例 RA 患者（28 个关节）进行临床和 US 检查。使用灰度（GS）和能量多普勒（PD）模式对滑膜积液、肥厚和血流进行半定量分级，范围为 0-3 级。我们计算了 US 调整后的简单疾病活动指数（SDAI），并通过与红细胞沉降率（ESR）和改良健康评估问卷（MHAQ）比较，评估了其可行性和外部有效性。

结果

GS≥2 和 PD≥0 对应于临床上肿胀的关节，而 GS≥2 和 PD≥1 对应于触痛的关节。当将 US 确定的肿胀关节定义为 ESR 时 PD≥2 且 GS≥3 且 PD≥2 与 MHAQ 时，US 调整后的 SDAI 显示出与 ESR 和 MHAQ 最高的相关性。仅检查临床受累关节的可行 US 调整后的 SDAI 与 ESR 和 MHAQ 的相关性仍高于 SDAI。