类风湿关节炎患者肌肉骨骼超声半定量分级与骨盐代谢、类风湿因子及红细胞沉降率的相关性分析及临床意义
Correlation analysis and clinical significance of Musculoskeletal Ultrasound semi-quantitative grading with bone salt metabolism, Rheumatoid factor and Erythrocyte Sedimentation rate in patients with Rheumatoid Arthritis.
作者信息
Song Pei-Ze, Wu Nan, Huo Cong, Wang Xiao-Ming
机构信息
Pei-ze Song, Dept. of Integrated Traditional Chinese and Western Medicine, Baoding NO.1 Central Hospital, Baoding 071000, Hebei, P.R. China.
Nan Wu, Dept. of Integrated Traditional Chinese and Western Medicine, Baoding NO.1 Central Hospital, Baoding 071000, Hebei, P.R. China.
出版信息
Pak J Med Sci. 2023 Nov-Dec;39(6):1652-1656. doi: 10.12669/pjms.39.6.7144.
OBJECTIVE
To determine the correlation and clinical significance of musculoskeletal ultrasound semi-quantitative grading with bone salt metabolism, rheumatoid factor and erythrocyte sedimentation rate (ESR) in patients with rheumatoid arthritis.
METHODS
This is a clinical comparative study. A total of 240 patients with rheumatoid arthritis admitted to Baoding NO.1 Central Hospital were selected according to the DAS28 score of rheumatoid arthritis, and were divided into four groups, with 60 cases in each group from May 2020 to May 2022. The differences and correlation of musculoskeletal ultrasound semi-quantitative grading, bone metabolism indicators, erythrocyte sedimentation rate and rheumatoid factor among the four groups were statistically analyzed.
RESULTS
The scores of bone erosion, synovial hyperplasia, joint effusion and intrasynovial blood flow in Group-H were significantly higher than those in Group-R, L and M, with statistically significant differences(p=0.00). The procollagen Type-1 N-terminal propeptide(P1NP), bone-specific alkaline phosphatase(BALP) and osteoprotegerin(OPG) in Group-H were significantly lower than those in Group-R, L and M, with statistically significant differences(p=0.00); The tartrate-resistant acid phosphatase(TRAC) in Group-H was significantly higher than that in Group-R, L and M, with a statistically significant difference(p=0.00). The levels of RF and ESR in Group-H were significantly higher than those in Group-R, L and M, with statistically significant differences(p=0.00).
CONCLUSION
Musculoskeletal ultrasound semi-quantitative grading is correlated with the level of bone salt metabolism, rheumatoid factor and ESR in patients with rheumatoid arthritis. It can be combined with laboratory examination to objectively judge the severity of the course of rheumatoid arthritis.
目的
探讨类风湿关节炎患者肌肉骨骼超声半定量分级与骨盐代谢、类风湿因子及红细胞沉降率（ESR）的相关性及临床意义。
方法
本研究为临床对比研究。根据类风湿关节炎的DAS28评分，选取2020年5月至2022年5月在保定市第一中心医院住院的240例类风湿关节炎患者，分为四组，每组60例。对四组患者的肌肉骨骼超声半定量分级、骨代谢指标、红细胞沉降率及类风湿因子的差异及相关性进行统计学分析。
结果
H组的骨侵蚀、滑膜增生、关节积液及滑膜内血流评分显著高于R组、L组和M组，差异有统计学意义（p = 0.00）。H组的Ⅰ型前胶原N端前肽（P1NP）、骨特异性碱性磷酸酶（BALP）及骨保护素（OPG）显著低于R组、L组和M组，差异有统计学意义（p = 0.00）；H组的抗酒石酸酸性磷酸酶（TRAC）显著高于R组、L组和M组，差异有统计学意义（p = 0.00）。H组的RF及ESR水平显著高于R组、L组和M组，差异有统计学意义（p = 0.00）。
结论
类风湿关节炎患者的肌肉骨骼超声半定量分级与骨盐代谢水平、类风湿因子及ESR相关。可结合实验室检查客观判断类风湿关节炎病程的严重程度。
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