【摘要】 目的探讨类风湿关节炎(RA)复发的相关因素及肌骨超声表现与疾病复发的相关性。方法选择严格随访且28个关节疾病活动评分-红细胞沉降率(DAS28-ESR)≤2.6持续至少3个月的RA患者。记录患者的临床资料及28个关节肌骨超声影像结果。保持原有治疗不变的基础上,观察患者后3个月的病情变化情况,将疾病复发(DAS28-ESR>2.6)的患者定义为疾病复发组,将疾病持续缓解的患者(DAS28-ESR≤2.6)定义为持续缓解组,比较两组各临床指标及超声影像的差异,应用多因素logistic回归进行相关因素分析。结果共63例患者纳入研究并行28个关节肌骨超声检查。3个月内疾病复发26例(41.3%),持续缓解37例(58.7%)。疾病复发组在亚临床滑膜炎检出率方面明显高于持续缓解组,在深度缓解率(DAS28-ESR<1.6)方面低于持续缓解组。亚临床滑膜炎是RA复发独立危险因素,而深度缓解是RA复发的保护因素。结论 RA复发与高疾病活动度及亚临床滑膜炎有关。更多还原

【Abstract】 Objective To investigate the relapses of rheumatoid arthritis(RA) and the correlation with musculoskeletal ultrasound.Methods A total of 63 RA patients whose erythrocyte sedimentation rate(DAS28-ESR) were continuously ≤2.6 were followed up strictly for at least 3 months. The clinical data and ultrasound results of 28 articular musculoskeletal specimens were recorded.With the persistence of the original treatment, patients’ 3-month clinical information were collected.Patients with disease recurrence(DAS28-ESR) were divided into the disease recurrence group, patients with disease continuous remission(DAS28-ESR≤2.6) were divided into the continuous remission group. The differences of clinical indexes and ultrasonography images between disease recurrence group and continuous remission group were compared by logistic regression analysis. Results A total of 26 cases with disease recurrence(41.3%) and 37 cases with continuous remission(58.7%) were observed within 3 months. Detection rate of subclinical synovitis of disease recurrence group was obviously higher than that of continuous remission group,while it was lower in depth remission rate(DAS28-ESR<1.6). Subclinical synovitis was an independent risk factor for the recurrence of RA, while the deep remission was a protective factor for the recurrence of RA. Conclusion The recurrence of RA was related to high disease activity and subclinical synovitis.更多还原