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目的探讨超声造影对于类风湿关节炎(RA)疾病活动性的评估价值。方法选取12例RA患者,选择病变最严重的关节进行造影,分析曲线下面积(AUC)、峰值强度(PI)和达峰时间(TTP)参数,探讨各参数与超声评分及4种生化检查(血沉ESR、C-反应蛋白CRP、类风湿因子RF、抗环瓜氨酸肽抗体AntiCCP)之间的相关性。结果超声造影时间-强度曲线中的AUC和PI与超声评分之间存在非常显著的相关性(rAUC=0.832,rPI=0.809,P<0.01),AUC和PI与ESR之间的相关性优于超声评分与ESR的相关性(rAUC=0.907,rPI=0.851,r超声评分=0.836,P<0.01),AUC和PI与CRP之间的相关性优于超声评分与CRP的相关性(rAUC=0.855,rPI=0.854,r超声评分=0.692,P<0.01)。结论超声造影对RA疾病活动性的诊断与超声评分和生化指标(ESR、CRP)基本吻合,且超声造影可能优于超声评分,更加能够反映RA疾病的活动性,可以提供更多的客观依据。
Objective To evaluate the value of contrast-enhanced ultrasound in the evaluation of rheumatoid arthritis (RA) disease activity. Methods A total of 12 patients with RA were enrolled in this study. The areas under the curve (AUC), peak intensity (PI) and time to peak (TTP) were selected to investigate the relationship between the parameters and ultrasound scores and the four biochemical tests Erythrocyte ESR, C-reactive protein CRP, rheumatoid factor RF, anti-cyclic citrullinated peptide antibody AntiCCP). Results There was a very significant correlation between AUC and PI in ultrasonic time-intensity curve and ultrasonic score (rAUC = 0.832, rPI = 0.809, P <0.01). The correlation between AUC, PI and ESR was better than that of ultrasound (RAUC = 0.907, rPI = 0.851, r ultrasound score = 0.836, P <0.01). The correlation between AUC, PI and CRP was better than that between ultrasound score and CRP (rAUC = 0.855, rPI = 0.854, r ultrasound score = 0.692, P <0.01). Conclusions Contrast-enhanced ultrasound (CEUS) and ultrasonography (ESR) and CRP are the most effective diagnostic criteria for RA disease. Contrast-enhanced ultrasonography may be the best method for contrast-enhanced ultrasonography. It can reflect the activity of RA more and provide more objective evidences.