中国组织工程研究

中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (24): 3773-3779.doi: 10.3969/j.issn.2095-4344.0861

• 骨组织构建 bone tissue construction •    下一篇

7个关节超声评分和超氧化物歧化酶在类风湿关节炎疾病活动度评估中的应用

许  佳1，高  嵩2，莫汉有1，石宇红1   

  1. 桂林医学院附属医院，1风湿免疫科，2超声科，广西壮族自治区桂林市  541001
  • 收稿日期:2018-01-04 出版日期:2018-08-28 发布日期:2018-08-28
  • 通讯作者: 石宇红，硕士，副主任医师，桂林医学院附属医院风湿免疫科，广西壮族自治区桂林市 541001
  • 作者简介:许佳，女，1980年生，汉族，广西壮族自治区桂林市人，硕士，讲师，主要从事类风湿关节炎研究。
  • 基金资助:

    国家自然科学基金项目(81460257)；广西壮族自治区卫生厅自筹课题项目(Z2013518)

Seven joints ultrasonic score and superoxide dismutase measurement for assessing the activity of rheumatoid arthritis

Xu Jia1, Gao Song2, Mo Han-you1, Shi Yu-hong1   

  1. 1Department of Rheumatology and Immunology, 2Department of Ultrasonography, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China
  • Received:2018-01-04 Online:2018-08-28 Published:2018-08-28
  • Contact: Shi Yu-hong, Master, Associate chief physician, Department of Rheumatism and Immunity, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China
  • About author:Xu Jia, Master, Lecturer, Department of Rheumatism and Immunity, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81460257; the Self-Financing Project of Health Department of Guangxi Zhuang Autonomous Region, No. Z2013518

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摘要：

文章快速阅读：

文题释义：
7个关节超声评分：Backhaus等学者提出应用7个关节超声评分方法对类风湿关节炎进行疾病活动评估。7个关节指的是临床症状最明显的患侧的腕关节、第2和3掌指关节、第2和3近端指间关节、第2和5跖趾关节。评价指标包括滑膜炎的灰阶超声、能量多普勒超声，腱鞘炎及肌腱炎的灰阶超声和能量多普勒超声、骨侵蚀。对上述指标进行半定量评分。Backhaus等在多个中心对120名类风湿关节炎患者进行7个关节超声评分法(US7评分)，发现其中滑膜炎灰阶超声评分与DAS28存在相关性，故认为该评分可作为有效的工具以监测类风湿关节炎疾病活动度。
超氧化物歧化酶：是人体重要的抗氧化酶，是清除人体自由基的重要物质。有研究表明，类风湿关节炎中有氧化应激反应机制的异常，可产生过多的氧自由基，引发异常活跃的氧化还原反应导致早发动脉粥样硬化，并损伤关节滑膜和软骨。有学者在关节炎小鼠和类风湿关节炎患者体内均发现超氧化物歧化酶水平和关节炎严重程度有关。
摘要
背景：类风湿关节炎是一种慢性、累及全身多个关节的自身免疫性疾病。目前已发现类风湿关节炎患者体内氧化应激反应异常，提示氧化应激参与类风湿关节炎的疾病进程。在对类风湿关节炎患者的治疗中，超声作为常见的影像学工具，在评价疗效上受到重视。
目的：探讨7个关节超声评分和超氧化物歧化酶在类风湿关节炎疾病活动度评价中的应用价值。
方法：选取2016年4月至2017年4月期间在桂林医学院附属医院风湿免疫科就诊(门诊及住院)的类风湿关节炎患者163例，根据28个关节疾病活动指数(DAS28)分为稳定期(n=20)、轻度(n=30)、中(n=70)、重度活动期(n=43)。另选同期健康体检者50例。检测所有受试者血清超氧化物歧化酶水平。以高频超声观察类风湿关节炎患者优势侧肢体7个关节，进行US7评分。应用US7评分及超氧化物歧化酶对类风湿关节炎疾病活动度进行评估。
结果与结论：轻、中、重度活动期的类风湿关节炎患者血清超氧化物歧化酶水平均低于健康体检者和稳定期类风湿关节炎患者。US7评分中，重度活动期类风湿关节炎患者的滑膜炎灰阶超声评分和能量多普勒评分、腱鞘炎和肌腱炎灰阶超声评分高于稳定期；骨侵蚀在各个活动度类风湿关节炎患者之间无明显差异。超氧化物歧化酶水平与滑膜炎灰阶超声评分、滑膜炎能量多普勒评分、DAS28和类风湿因子负相关；DAS28与滑膜炎灰阶超声评分、滑膜炎能量多普勒评分、腱鞘炎及肌腱炎灰阶超声评分和腱鞘炎及肌腱炎能量多普勒评分正相关。DAS28、超氧化物歧化酶与骨侵蚀无明显相关性。提示超氧化物歧化酶与US7评分中除骨侵蚀以外的指标和DAS28密切相关，超氧化物歧化酶和US7评分可用于评估类风湿关节炎疾病活动度。

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程
ORCID: 0000-0003-0565-3433(许佳)

关键词: 超声；超氧化歧化酶；类风湿关节炎；疾病活动度；滑膜炎；灰阶超声评分, 能量多普勒评分；类风湿因子

Abstract:

BACKGROUND: Rheumatoid arthritis (RA) is a chronic, autoimmune disease involving multiple joints throughout the body. Patients with RA exhibit abnormal oxidative stress, suggesting that oxidative stress is involved in the process of RA. Ultrasound is a commonly used imaging method for assessing the efficacy of RA.
OBJECTIVE: To explore the value of seven joints ultrasonic score and superoxide dismutase level in the evaluation of activity of RA.
METHODS: A total of 163 patients with RA who received treatment in the Department of Rheumatology and Immunology, Affiliated Hospital of Guilin Medical University from April 2016 to April 2017 were selected and divided into two groups based on disease activity score 28 (DAS28) remission (n=20), mild (n=30), moderate (n=70), and severe activity (n=43). Another 50 cases who received health examination at the same period were included. All subjects were tested for serum superoxide dismutase level. High-frequency ultrasound was used to observe the superior limbs of seven joints in patients with RA and to evaluate the US7 score. US7 score and superoxide dismutase level were used to assess the disease activity of RA.
RESULTS AND CONCLUSION: The level of serum superoxide dismutase in patients with mild, moderate and severe active RA was significantly higher than that in the healthy controls and remission of RA patients. In US7 score, patients with severe active RA had higher 
synovitis gray scale ultrasound score, power Doppler ultrasound score, tenosynovitis and tendonitis gray scale ultrasound scores than patients in the remission period. There was no significant difference in bone erosion in all activities of rheumatoid arthritis between patients. The level of superoxide dismutase was negatively correlated with the gray scale ultrasound score of synovitis, the power Doppler score of synovitis, the DAS28 and the rheumatoid factor. DAS28 was positively correlated with synovitis gray scale, synovitis power Doppler score, tenosynovitis and tendonitis gray scale ultrasound scores and tenosynovitis and tendonitis power Doppler score. DAS28 and superoxide dismutase showed no significant correlation with bone erosion. These findings suggest that the index of superoxide dismutase and the score of US7 in addition to bone erosion are closely related to DAS28. Detection of superoxide dismutase level and US7 scores can be used to assess the disease activity of RA.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Arthritis, Rheumatoid, Ultrasonography, Tissue Engineering

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