网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
超微血管成像技术半定量分级与类风湿关节炎患者骨代谢平衡的相关性分析
作者:李风娟1  晋秀丽1  杜建文1  王洪1  白静2 
单位:1. 承德市中心医院 超声诊断科, 河北 承德 067000;
2. 承德市第三医院 超声诊断科, 河北 承德 067000
关键词:超微血管成像 类风湿关节炎 骨代谢 相关性 
分类号:R593.22;R445.1
出版年·卷·期(页码):2020·48·第九期(1112-1117)
摘要:

目的:研究超微血管成像技术(SMI)半定量分级与类风湿关节炎(RA)患者骨代谢情况的相关性。方法:选取2017年3月至2018年7月在我院诊断为类风湿性关节炎(RA)的病人131例。根据DAS28结果将病人分为疾病缓解期(20例)、轻度活动期(41例)、中度活动期(46例)及重度活动期(24例)4组。超声SMI模式评估各组患者关节滑膜内血流信号。全自动生化分析仪检测患者血清中骨形成标志物骨保护素(OPG)、I型前胶原氨基端前肽(PINP)、I型前胶原羧基端前肽(PICP)、I型胶原C端肽(CTX-I)、抗酒石酸酸性磷酸酶5b(TRACP5B)及骨碱性磷酸酶(BALP)的水平。对不同疾病程度RA患者SMI半定量评分和各标志物水平进行单因素方差分析,同时分析SMI半定量评分与DAS28及各标志物的相关性。结果:疾病活动度高组的患者SMI半定量分级评分明显高于活动度低组患者(F=97.516,P<0.01)。疾病活动度高的患者OPG(F=51.292,P<0.01)、PINP(F=102.545,P<0.01)、PICP(F=144.512,P<0.01)、BALP(F=178.535,P<0.01)水平明显高于活动度低组患者(均P<0.05),疾病活动度高组患者CTX-I(F=30.450,P<0.01)和TRACP5B F=118.151,P<0.01)水平明显低于活动度低组患者,且两两之间有显著性差异(均P<0.01))。相关性分析显示,SMI半定量评分与DAS28正相关(R2=0.486 2,P<0.01),与OPG(R2=0.372 5,P<0.01)、PINP(R2=0.484 2,P<0.01)、PICP(R2=0.485 7,P<0.01)、BALP(R2=0.475 9,P<0.01)负相关,与CTX-I(R2=0.237 4,P<0.01)和TRACP5B(R2=0.437 5,P<0.01)正相关。结论:SMI分级随RA患者疾病活动程度加重而升高,并且与骨代谢状态相关。

Objective: To study the relationship between semi-quantitative scoring of superb microvascular imaging and markers of bone metabolism in patients with rheumatoid arthritis.Methods: A total of 131 patientsdiagnosed with rheumatoid arthritis(RA) in our hospital from March 2017 to July 2018 were enrolled in this study. According to the DAS28 scores, patients were divided into 4 groups:remission group(20 patients), mild-active group (41 patients), moderate-active group(46 patients) and severe-active group(24 patients). The synovial flow signals were provided by the superb microvascular imaging(SMI) pattern of ultrasound. Patients were graded by SMI semi-quantitative scoring. Moreover, the serum levels of osteoprotegerin(OPG), procollagen type I N-terminal propetide(PINP), propeptide of type I procollagen(PICP), carboxy-terminal telopeptide of type I collagen(CTX-I), tartrate-resistant acid phosphatase 5B(TRACP5B) and bone alkaline phosphatase(BALP) were detected. The SMI scores and the level of these six markers of the 4 groups were compared. The relationship of SMI with DAS28 score and levels of the six markers were analyzed by Pearson correlation analysis.Results: The SMI scores in patients with high disease activity were higher than those in patients with low disease activity(F=97.516,P<0.01). The levels of OPG(F=51.292, P<0.01), PINP(F=102.545, P<0.01), PICP(F=144.512, P<0.01), BALP (F=178.535, P<0.01), CTX-I(F=30.450, P<0.01) and TRACP5B(F=118.151, P<0.01) in patients with high disease activity were lower than those in patients with low disease activity. Correlation analysis showed that the SMI score was negatively correlated with the level of OPG(R2=0.372 5,P<0.01), PINP(R2=0.484 2,P<0.01), PICP(R2=0.4857,P<0.01), BALP (R2=0.475 9,P<0.01), and positively correlated with DAS28 scores and the level of CTX-I(R2=0.237 4,P<0.01) and TRACP5B(R2=0.437 5,P<0.01).Conclusion: The SMI grades of RA patients increase with patients' disease activity, and are correlated with bone metabolism.

参考文献:

[1] MCINNES I B,SCHETT G.Pathogenetic insights from the treatment of rheumatoid arthritis[J].Lancet,2017,389(10086):2328-2337.
[2] GARNERO P.New developments in biological markers of bone metabolism in osteoporosis[J].Bone,2014,66:46-55.
[3] ABDELGHANI K B,MILADI S,SOUABNI L,et al.Role of ultrasound in assessing remission in rheumatoid arthritis[J].Diagn Interv Imag,2015,96(1):3-10.
[4] ALETAHA D,NEOGI T,SILMAN A J,et al.2010 rheumatoid arthritis classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative[J].Arthritis Rheum,2010,62(9):2569-2581.
[5] MCWILLIAMS D F,KIELY P D W,YOUNG A,et al.Interpretation of DAS28 and its components in the assessment of inflammatory and non-inflammatory aspects of rheumatoid arthritis[J].BMC Rheumatol,2018,2(1):8.
[6] SOUBRIER M,PEREIRA B,FRAYSSAC T,et al.Retention rates of adalimumab,etanercept and infliximab as first-line biotherapy agent for rheumatoid arthritis patients in daily practice Auvergne experience[J].Int J Rheum Dis,2018,21(11):1924-1932.
[7] SHAW Y,METES I D,MICHAUD K,et al.Rheumatoid arthritis patients' motivations for accepting or resisting disease-modifying antirheumatic drug treatment regimens[J].Arthritis Care Res,2018,70(4):533-541.
[8] 李丽,叶玉泉,陈京京,等.超微血管成像技术评估类风湿活动性关节炎:与CDFI和CEUS对比[J].中国医学影像技术,2016,32(10):1569-1571.
[9] 刘欢颜,杜建文,王洪,等.超微血管成像技术在类风湿关节炎滑膜血管翳中的应用价值[J].中国临床新医学,2018,11(12):1219-1222.
[10] ORLANDI D,GITTO S,BERNARDI S P,et al.Advanced power Doppler technique increases synovial vascularity detection in patients with rheumatoid arthritis[J].Ultrasound Med Biol,2017,43(9):1880-1887.
[11] 李丽,叶玉泉,张捷思,等.微血流成像技术在类风湿关节炎患者手腕关节中的应用价值[J].中国超声医学杂志,2016;32(11):1004-1006.
[12] 李静,红华,孙爱童,等.微血管成像技术对类风湿性关节炎临床缓解期滑膜炎症活跃性的评价[J].中国超声医学杂志,2018,34(6):540-542.
[13] LI W,LIU F,ZHU J,et al.Superb micro-vascular imaging improving inflammatory flow blood sensitivity in patients with rheumatoid arthritis[J].Int J Clin Exp Med,2016,9(10):19930-19934.
[14] 余倩,胡志东.类风湿关节炎患者骨代谢标志物研究进展[J].国际流行病学传染病学杂志,2015,42(1):45-47.
[15] CHAVASSIEUX P,PORTERO-MUZY N,ROUX J P,et al.Are biochemical markers of bone turnover representative of bone histomorphometry in 370 postmenopausal women[J].J Clin Endocrinol Metab,2015,100(12):4662-4668.
[16] SZULC P,NAYLOR K,HOYLE N R,et al.Use of CTX-I and PINP as bone turnover markers:National Bone Health Alliance recommendations to standardize sample handling and patient preparation to reduce pre-analytical variability[J].Osteoporosis Int,2017,28(9):2541-2556.
[17] MOCHIZUKI T,YANO K,IKARI K,et al.Effects of denosumab treatment on bone mineral density and joint destruction in patients with rheumatoid arthritis[J].J Bone Miner Metab,2018,36(4):431-438.
[18] SHAFIEY S I,MOHAMED W R,ABO-SAIF A A.Paroxetine and rivastigmine mitigates adjuvant-induced rheumatoid arthritis in rats:Impact on oxidative stress,apoptosis and RANKL/OPG signals[J].Life Sci,2018,212:109-118.
[19] 陈美西,刘秉彦,林坚平,等.类风湿关节炎患者肌骨超声半定量分级与疾病活动度及骨代谢平衡的关系[J].山东医学,2017,57(32):68-70.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 399334 位访问者


 ©《现代医学》编辑部
联系电话:025-83272481;83272479
电子邮件: xdyx@pub.seu.edu.cn

苏ICP备09058541