| 沈华良,刘夏天,谭燕,胡寅峰.肌肉骨骼超声对老年痛风性关节炎的诊断价值[J].中国临床保健杂志,2017,20(4):376-378. |
| 肌肉骨骼超声对老年痛风性关节炎的诊断价值 |
| Diagnostic value of musculoskeletal ultrasound in elderly patients with gouty arthritis |
| 投稿时间：2017-03-11 |
| DOI：10.3969/J.issn.1672-6790.2017.04.012 |
| 中文关键词: 关节炎,痛风性 超声检查,多普勒,彩色 肌,骨骼 老年人 |
| 英文关键词: Arthritis,gouty Ultrasonography,doppler,color Muscle,skeletal Aged 〖FL |
| 基金项目:浙江省医药卫生一般研究计划(2014KYB234) |
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| 中文摘要: |
| 目的 探讨老年痛风性关节炎(GA)患者应用肌肉骨骼超声诊断的临床效果。方法 选取44例GA老年患者作为研究组,再选取同期间的类似表现的其他疾病患者44例为对照组。应用肌肉骨骼超声检查两组的滑膜增生、软组织肿胀、骨侵蚀、滑囊骨化以及腱鞘炎等情况,根据两组表现对痛风的典型症状使用超声的敏感性和特异性进行评价。结果 研究组共有66处关节病变,对照组共64处,对两组的第一跖趾关节、近端指间关节、肩关节、踝关节、腕关节和膝关节数进行统计发现,两者在腕关节和膝关节上关节病变数差异有统计学意义(P＜0.05)；两组在滑膜增生、滑囊骨化上差异无统计学意义(P>0.05)；研究组痛风石和韧带内高回声点的发生率分别为18.18%、28.79%,而对照组均无发生,且两组双边征、高回声点的发生率差异有统计学意义(P＜0.05)。痛风石、高回声点、双边征和韧带内高回声点为GA的典型症状,以上情况如果在超声诊断中单独出现,则认为痛风的敏感性较低、特异性较高,若发生一项以上,说明敏感性和特异性需要提高,在本研究中,以上四项的敏感性和特异性均较高；两组软组织肿胀、骨侵蚀和腱鞘炎的发生率差异有统计学意义(P＜0.05)。结论 肌肉骨骼超声具有高敏感性和准确性,值得在老年GA的诊断中推广使用。 |
| 英文摘要: |
| Objective To investigate the clinical effect of musculoskeletal ultrasound in the diagnosis of gouty arthritis (GA) in the elderly.Methods 44 elderly patients with GA were selected as the study group,and 44 patients with similar diseases in the same period were selected as the control group.By using musculoskeletal ultrasound,the indexes of synovial hyperplasia,soft tissue swelling,bone erosion,bursa ossification and tenosynovitis etc.in the two groups were inspected,and to evaluated ultrasound sensitivity and specificity according to showed typical symptoms of gout.Results A total of 66 joint disease were inspected in the study group,64 in the control group,statistics the first metatarsophalangeal joint,proximal interphalangeal joint,shoulder joint,ankle,wrist and knee joint number in the two groups,it found that there were statistical significance differences in the wrist and knee joint lesion number (P<0.05);in the two groups synovial hyperplasia,bursa ossification had no significant difference (P>0.05);the incidence rate of tophus and hyperechoic ligament points was 18.18%,28.79% in the study groups,while in the control group it had no occurred,and the incidence of bilateral high echo syndrome was statistically significant between the two groups (P<0.05) High echo points,bilateral signs,and hyperechoic points in the ligament were the typical symptoms of GA,if the above appeared alone in ultrasonic diagnosis,it indicate that the sensitivity is low and the gout specificity is high,if the above appeared more than one,it indicate that the sensitivity and specificity were all needing to be improved.In this study,sensitivity and specificity in all the above of four were high;and in the two groups the incidence rate of soft tissue swelling,bone erosion and tenosynovitis were all statistically significant (P<0.05).Conclusion The musculoskeletal ultrasound has high sensibility and accuracy,and the ultrasonic imaging manifestation is obvious,it is worthy to be popularized in the diagnosis of GA in the elderly. |
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