中国实用内科杂志2024，Vol.44Issue(12)：1039-1043,1048,6.DOI:10.19538/j.nk2024120113
超声随访中图像特征与痛风性关节炎降尿酸疗效的相关性研究
Correlation between image features in ultrasound follow-up and urate-lowering therapic efficacy in gouty arthritis
摘要
Abstract
Objective To analyze the changes in ultrasound characteristics in urate-lowering therapy(ULT)for gouty arthritis.Methods A total of 65 patients with gouty arthritis who received ULT at Nanjing Drum Tower Hospital from January 2018 to January 2019 and were with a 1-year follow-up were selected.Based on adherence to uric acid-lowering medication,patients were divided into two groups:compliance group(n=38)and non-compliance group(n=27).Ultrasound images(double contour sign,tophus)and clinical data[serum uric acid(SUA),visual analogue scale(VAS),patient global assessment(PGA)]were collected at baseline,and at 3,6,and 12 months after ULT.The relationship between clinical indicators and the changes in ultrasound characteristics was analyzed.Results Compared with before treatment,VAS and PGA in compliance group were lower than those in non-compliance group after 3 months of ULT,with significant differences between the two groups[VAS:compliance group 3.00(0,5.00)vs.non-compliance group 5.00(3.75,7.00),Z=-2.757,P=0.006;PGA:compliance group 5.00(3.00,6.00)vs.non-compliance group7.00(5.75,8.25),Z=-4.326,P＜0.001].After 6 months of ULT,SUA levels differed significantly between the two groups[compliance group(388.42±81.35)µmol/L vs.non-compliance group(462.42±146.85)μmol/L,t=2.600,P=0.012].After 12 months of ULT,the proportion of patients with SUA levels ≤300 μmol/L was significantly higher in compliance group than in non-compliance group(26.32％vs.3.7％,x2=4.245,P=0.039).Additionally,the number of double contour sign in compliance group decreased more significantly than in non-compliance group(24 vs.1),and the difference was statistically significant(x2=7.502,P=0.006)after 12 months of ULT.The tophus area decreased in compliance group[0.85(0.61,1.42)cm2 vs.0.69(0.23,1.47)cm2]compared with that before ULT,while it increased in non-compliance group[0.49(0,0.95)cm2 vs.0.85(0.63,1.25)cm2].After 12 months of ULT,there was a significant difference in tophus area between the two groups[compliance group 0.69(0.23,1.47)cm2 vsnon-compliance group 0.85(0.63,1.25)cm2,Z=-2.153,P=0.031].Conclusion ULT can improve clinical symptoms and ultrasound characteristics of patients with gouty arthritis,and compliance group shows greater improvement in all indexes than non-compliance group.关键词
痛风/降尿酸治疗/超声/双轨征/痛风石Key words
gouty/urate-lowering therapy/ultrasonund/double contour sign/tophus分类
医药卫生引用本文复制引用
赵获,张玮婧,王颖,姚静,金志斌..超声随访中图像特征与痛风性关节炎降尿酸疗效的相关性研究[J].中国实用内科杂志,2024,44(12):1039-1043,1048,6.基金项目
国家自然科学基金面上项目(82371981) （82371981）
