【摘要】 目的 探讨频发型与偶发型痛风足踝部双能CT(DECT)影像学征象与临床及实验室指标的差异性。方法 回顾性选取痛风患者385例,根据临床表现分为频发组(痛风发作≥2次/年)219例和偶发组(痛风发作<2次/年)166例。分别收集患者临床资料、实验室指标及DECT影像学检查资料,进行统计学分析,采用二分类logistic回归分析痛风频发的独立危险因素,并绘制受试者工作特征(ROC)曲线。结果 频发组与偶发组在病程、体质量指数(BMI)、血压、甘油三酯(TG)、血清尿酸(SUA)、单钠尿酸盐(MSU)晶体沉积、MSU晶体总体积、单个痛风石最长径、累及关节数、骨侵蚀、骨侵蚀最大深度、软组织肿胀、骨质增生硬化、关节间隙变窄方面有显著差异(P<0.05)。SUA水平、MSU晶体沉积、MSU晶体总体积、骨侵蚀最大深度是频发型痛风的独立危险因素(P<0.05)。4个因素联合模型与骨侵蚀最大深度模型均有较高诊断效率。结论 SUA水平高、有MSU晶体沉积、MSU晶体总体积大、骨侵蚀最大深度深的痛风患者更易痛风频发;当痛风患者骨侵蚀最大深度>3.200 mm时更易早期识别频发型痛风。更多还原

【Abstract】 Objective To explore the differences in the radiological features, clinical, and laboratory indicators of frequent versus infrequent gout flares in the feet and ankles using dual-energy computed tomography(DECT). Methods A retrospective selection was made on 385 gout patients, who were divided into the frequent flare group(≥2 gout attacks per year,219 cases) and the infrequent flare group(<2 gout attacks per year,166 cases). Clinical data, laboratory indicators, and DECT imaging findings were collected for statistical analysis. Binary logistic regression was used to analyze the independent risk factors for frequent gout flares and receiver operating characteristic(ROC) curve was plotted. Results Statistically significant differences were found between the frequent flare group and the infrequent flare group in terms of disease duration,body mass index(BMI),blood pressure,triglyceride(TG),serum uric acid(SUA),monosodium urate(MSU) crystal deposition,total volume of MSU crystals,maximum diameter of individual tophi,number of affected joints,bone erosion,maximum depth of bone erosion,soft tissue swelling,bone proliferation and sclerosis,and joint space narrowing(P<0.05).SUA levels,MSU crystal deposition,total volume of MSU crystals,and maximum depth of bone erosion were identified as independent risk factors for frequent gout(P<0.05).Both the combination of four factors model and the maximum depth of bone erosion model had better diagnostic efficacy. Conclusion Gout patients with high SUA levels,MSU crystal deposition,larger total volume of MSU crystals,and greater maximum depth of bone erosion are more likely to experience frequent gout attacks.Patients with bone erosion depth >3.200 mm are more likely identified early as having frequent gout.更多还原