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目的探析肌肉骨骼超声(MSUS)对痛风性关节炎的临床诊断效果。方法 36例痛风性关节炎患者作为试验组,38例其他关节炎患者作为对照组。两组均行MSUS检查腱鞘炎、骨侵蚀、痛风石、韧带等症状,对炎症情况进行评估,评价MSUS诊断价值。结果试验组患者中,经MSUS检查发现受累关节51个,其中近端指尖关节5个,踝关节18个,腕关节16个,膝关节12个。对照组患者中,经MSUS检查发现受累关节62个,其中近端指尖关节10个,踝关节21个,腕关节17个,腕关节14个。试验组腱鞘炎及骨侵蚀例数少于对照组;痛风石,韧带内高回声点,高回声点,平行线,出现韧带内高回声点、痛风石、平行线、高回声点≥1个表现例数多于对照组,差异均具有统计学意义(P<0.05)。MSUS诊断痛风性关节炎的敏感性为68.2%,特异性为94.6%。ROC AUC=0.860,诊断的准确度中等(P<0.05),一致性中等(P<0.05)。结论 MSUS检查得出痛风石、高回声点和平行线等情况,在痛风性关节炎病症的诊断中能起到重要作用。
Objective To investigate the clinical diagnosis of gouty arthritis by Musculoskeletal Ultrasound (MSUS). Methods Thirty-six patients with gouty arthritis were selected as experimental group and 38 patients with other arthritis as control group. Both groups were performed MSUS examination of tenosynovitis, bone erosion, tophi, ligaments and other symptoms, the assessment of inflammation, evaluation of MSUS diagnostic value. Results In the test group, there were 51 affected joints found by MSUS, including 5 proximal fingertips, 18 ankle joints, 16 wrist joints and 12 knee joints. In the control group, 62 affected joints were found by MSUS examination, including 10 proximal fingertip joints, 21 ankle joints, 17 wrist joints and 14 wrist joints. The number of cases of tenosynovitis and bone erosion in the experimental group was less than that of the control group. The incidence of tenosynovitis and bony erosions in the tophi and ligaments was higher than that in the control group More than the control group, the differences were statistically significant (P <0.05). The sensitivity of MSUS in the diagnosis of gouty arthritis was 68.2% and the specificity was 94.6%. The AUC of ROC was 0.860, the diagnostic accuracy was moderate (P <0.05), and the consistency was moderate (P <0.05). Conclusion The results of MSUS showed that tophi, hyperechogenic point and parallel lines could play an important role in the diagnosis of gouty arthritis.