高级检索

类风湿关节炎患者亚临床滑膜炎的临床特征分析

Analysis in clinical characteristics of subclinical synovitis in patients with rheumatoid arthritis

    摘要
  • 摘要:
      目的  分析类风湿关节炎（RA）患者亚临床滑膜炎的发生率、临床特征及影响因素。
      方法  分析治疗6个月后获得临床缓解的146例RA患者亚临床滑膜炎发生情况。按肌骨超声结果分为亚临床滑膜炎组和超声缓解组，比较2组临床及超声特征。采用受试者工作特征（ROC）曲线评估RA亚临床滑膜炎发生的预测因素。观察抗风湿治疗对RA患者亚临床滑膜炎发生率的影响。
      结果  治疗6个月时，在达到以红细胞沉降率计算的28个关节疾病活动度评分（DAS28-ESR）、以C反应蛋白计算的28个关节疾病活动度评分（DAS28-CRP）、临床疾病活动指数（CDAI）、简化疾病活动指数（SDAI）的缓解标准的RA患者中，有49例（45.4%）、66例（46.2%）、35例（41.7%）、34例（41.0%）存在亚临床滑膜炎。亚临床滑膜炎组患者的CRP水平及DAS28-ESR、DAS28-CRP、CDAI、SDAI评分高于超声缓解组患者，差异有统计学意义（P=0.020、0.007、0.001、0.002、0.001）。亚临床滑膜炎组患者的滑膜增生评分（GS评分）高于超声缓解组患者，差异有统计学意义（P=0.001）。ROC曲线显示，基线时GS评分、滑膜血流评分能预测亚临床滑膜炎发生。治疗6个月和1年时，RA患者亚临床滑膜炎发生率均下降。
      结论  RA患者达到临床缓解标准后仍可能存在亚临床滑膜炎，而亚临床滑膜炎患者的CRP、疾病活动度、GS评分较高。基线时的GS评分和滑膜血流评分能预测亚临床滑膜炎的发生。有效的抗风湿治疗可以减少亚临床滑膜炎的发生。

     

    Abstract:
      Objective  To analyze the incidence, clinical characteristics and influencing factors of subclinical synovitis in patients with rheumatoid arthritis (RA).
      Methods  The occurrence of subclinical synovitis in 146 RA patients with clinical remission after 6 months of treatment was analyzed. According to the results of musculoskeletal ultrasound, they were divided into subclinical synovitis group and ultrasound remission group, and clinical and ultrasonic features of two groups were compared. The predictive factors of subclinical synovitis in RA were evaluated by receiver operating characteristic (ROC) curve. Effect of anti-rheumatism treatment on the incidence of subclinical synovitis in RA patients was observed.
      Results  At 6 months of treatment in RA patients who met the remission criteria of Disease Activity Score in 28 joints calculated by erythrocyte sedimentation rate (DAS28-ESR), Disease Activity Score in 28 joints calculated by C reaction protein (DAS28-CRP), Clinical Disease Activity Index (CDAI) and Simplified Disease Activity Index (SDAI), the subclinical synovitis was found in 49 cases (45.4%), 66 cases (46.2%), 35 cases (41.7%) and 34 cases (41.0%) respectively. The CRP level and DAS28-ESR, DAS28-CRP, CDAI and SDAI scores in the subclinical synovitis group were significantly higher than those in ultrasound remission group (P=0.020, 0.007, 0.001, 0.002 and 0.001). The synovial hyperplasia score (GS score) in subclinical synovitis group was significantly higher than that in ultrasound remission group (P=0.001). ROC curve showed that GS score and synovial blood flow score at baseline could predict the occurrence of subclinical synovitis. The incidence of subclinical synovitis in RA patients decreased after 6 months and 1 year of treatment.
      Conclusion  Patients with RA may still have subclinical synovitis after reaching clinical remission criteria, while patients with subclinical synovitis have higher CRP level, disease activity and GS scores. GS score and synovial blood flow score at baseline can predict the occurrence of subclinical synovitis. Effective anti-rheumatic therapy can reduce the incidence of subclinical synovitis.

     

    • HTML全文
    • 参考文献(19)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回