肌肉骨骼超声诊断足踝部痛风性关节炎的应用

摘要/Abstract

摘要： 目的分析肌肉骨骼超声诊断足踝部痛风性关节炎的临床应用效果。方法选取2019年6月~2020年6月牡丹江市中医医院收治的疑似足踝部痛风性关节炎患者120例作为研究对象并对其临床资料进行回顾性分析,所有研究对象均接受肌肉骨骼超声检查以及磁共振检查进行临床初诊,并以最终临床诊断做为金标准,比较两种检查方法的诊断结果。结果肌肉骨骼超声诊断足踝部痛风的敏感度以及阴性预测值均明显低于磁共振检查,差异有统计学意义（P<0.05）,但是二者在特异性、诊断准确性、阳性预测值方面对比,差异无统计学意义（P>0.05）;经比较两种诊断具有较好的一致性（Kappa=0.545）。结论肌肉骨骼超声检查用于诊断足踝部痛风性关节炎准确性高,临床具有较高的应用价值。

关键词: 肌肉骨骼超声诊断, 足踝部痛风性关节炎, 磁共振, 准确性, 敏感度, 特异性

Abstract: Objective To analyze the clinical effect of musculoskeletal ultrasound in the diagnosis of gouty arthritis of foot and ankle. Methods One hundred and twenty patients with suspected gouty arthritis of foot and ankle admitted to Mudanjiang Hospital of Traditional Chinese Medicine from June 2019 to June 2020 were selected as the research objects, and their clinical data were analyzed retrospectively. The subjects were examined by musculoskeletal ultrasonography and MRI for the first clinical diagnosis, with the final clinical diagnosis as the gold standard.The diagnosis results of the two methods was compared. Results The sensitivity and negative predictive value of musculoskeletal ultrasound in diagnosing gout of foot and ankle were significantly lower than those of MRI, the difference has statistical significant (P<0.05), but there was no statistically significant difference in specificity, diagnostic accuracy and positive predictive value between them (P>0.05); The two diagnoses were in good agreement (Kappa = 0.545). Conclusion Musculoskeletal ultrasonography has high accuracy in diagnosing gouty arthritis of foot and ankle, and has high clinical application value.

Key words: ultrasonic diagnosis of musculoskeletal, gouty arthritis of foot and ankle, magnetic resonance, accuracy, sensitivity, specificity

中图分类号:

R445.1

田甜. 肌肉骨骼超声诊断足踝部痛风性关节炎的应用[J]. 中华养生保健, 2022, 40(9): 10-13.

TIAN Tian. Application of Musculoskeletal Ultrasound in Diagnosis of Gouty Arthritis of Foot and Ankle[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(9): 10-13.

参考文献

[1] Cabău G,Crișan T O,Klück V,et al.Urate‐induced immune programming: Consequences for gouty arthritis and hyperuricemia[J].Immunological reviews,2020,294(1):92-105.
[2] 张丁丁,安娜,李贺霞,等.肌肉骨骼超声检查在痛风性关节炎患者中的应用[J].影像研究与医学应用,2021,5(10):51-52.
[3] 陈亮,王新伟.痛风性关节炎的肌肉骨骼超声表现及超声诊断价值研究[J].中国伤残医学,2021,29(23):60-61.
[4] 倪然,陈睿,余顺.肌肉骨骼超声在痛风性关节炎不同时期检查中的应用[J].临床与病理杂志,2020,40(8):2138-2142.
[5] 侯玲霞,吕海霞,张周龙.肌肉骨骼超声在痛风性关节炎中的应用价值[J].国际医药卫生导报,2021,27(18):2823-2825.
[6] 曾学军. 《2015年美国风湿病学会/欧洲抗风湿联盟痛风分类标准》解读[J].中华临床免疫和变态反应杂志,2015,9(4):235-238.
[7] 黄蓉,张前茜,冯瑞卿.肌肉骨骼超声在足踝部痛风性关节炎诊疗中的应用研究[J].影像研究与医学应用,2020,4(9):209-210.
[8] Balata M G,Helal A H,Mohamed A H,et al.Gouty arthritis and kidney function outcomes and serum uric acid level variations in obese patients following bariatric surgery[J].The Egyptian Journal of Internal Medicine,2022,34(1):1-7.
[9] 王铮,袁建军.肌肉骨骼超声在无症状高尿酸血症及痛风中的应用[J].中国医学影像学杂志,2018,181(6):68-70,72.
[10] 杨冬,李怡红,朱庆军.肌肉骨骼超声对痛风性关节炎的诊断意义[J].中国妇幼健康研究,2017,28(3):175.
[11] 杨赟. 肌肉骨骼超声诊断足踝部痛风性关节炎的应用效果分析[J].影像研究与医学应用,2019,3(10):223-224.
[12] 郭卫红,黄晓云,李斌,等.肌肉骨骼超声诊断鉴别足踝部痛风性关节炎意义分析[J].黑龙江医学,2019,43(3):253-254.
[13] 庄艳芳,庄慧芳,王慧娟.肌肉骨骼超声与MRI在老年痛风性关节炎患者诊治中的应用[J].中国CT和MRI杂志,2020,18(5):129-132.
[14] 路茂青,刘志红.肌肉骨骼超声检查在痛风性关节炎患者中的应用价值[J].医学影像学杂志,2019,29(12):2118-2120.
[15] 周锦朋. 肌肉骨骼超声诊断足踝部痛风性关节炎的应用价值研究[J].中国伤残医学,2020,28(22):39-41.