超声滑膜炎评分对早期类风湿.PDFVIP

浙江医学2018 年第40 卷第23 期 超声滑膜炎评分对早期类风湿 性关节炎短期复发风险的预测 价值研究 侯春杰 汤靖岚 何跟山 何洪峰 胡巧洪 莹 张帆 范小明 摘要 】 目的 探讨 7 关节超声评分法 (7-joints ultrasound score ，US7) 中的滑膜炎评分对早期类风湿性关节炎 （rheumatoid arthritis ，RA ）患者临床缓解后短期复发风险的预测价值。方法 选择早期 RA 患者 132 例，均在进行抗风湿药物治 疗后达到临床缓解，即疾病活动性评分（disease activity score in 28 joints ，DAS28 ）＜2 .6 ，并连续维持≥6 个月。根据 12 个月随 访期内是否复发分为复发组和未复发组。比较两组随访基线时的US7 滑膜炎评分差异，并应用 ROC 曲线评估 US7 滑膜炎评分 对 RA 患者临床缓解后短期复发风险的预测效能。结果 复发组与未复发组的能量多普勒（PD ）滑膜炎关节数、PD 评分以及滑 膜炎总评分差异均有统计学意义（P＜0 .01 或0 .05 ），其中PD 评分的AUC 最大（0 .772 ）。以PD 评分≥1 作为是否复发的预测临 界值，灵敏度62.9% ，特异度80 .4% 。结论 US7 滑膜炎评分法，尤其是PD 评分对RA 临床缓解后短期复发具有良好的预测效能。 关键词】 类风湿性关节炎 滑膜炎 复发 预测 Value of ultrasound synovitis score in predicting relapse of rheumatoid arthritis patients with clinical remission China Abstract 】 Objective To evaluate the value of ultrasound synovitis score in predicting relapse of rheumatoid arthritis (RA) patients with clinical remission. Methods One hundred and thirty two RA patients with a disease activity DAS28 score ≤2.6 at least 6 months were followed for 12 months, and the relapse was defined as DAS ＞2.6 at the follow-up visit. The US7 synovitis scores were recorded and compared between the relapse patients and non-relapse patients. Results There were significant differences in power Doppler (PD) joint counts ，PD scores and synovitis total scores (2 vs 0, 2 vs 0, 6 vs 4; all P ＜0.05) between relapse and non-relapse groups. The area under ROC curve (AUC) of PD scores was 0.772; when set PD scores ≥1 as a cut-off point, the sensitivity and specificity in predicting relapse were 62.9% and 80.4%, respectively. Conclusion Ultrasound synovitis scores, especially PD scores may predict relapse of RA patients in clinical remission. Key words 】 Rheumatoid arthritis Synovitis Relapse Predict [1-2] 类风湿性关节