超声在无症状高尿酸血症关节病变中的应用

Application of high-frequency ultrasound in screening of arthropathy in patients with asymptomatic hyperuricemia

摘要:

目的 探讨高频超声对无症状高尿酸血症患者关节病变的早期筛查价值。方法 选取164 例无 症状高尿酸血症患者及100 例健康对照者。对双侧第一跖趾关节、踝关节及膝关节进行高频超声检查，分析 两组病变关节阳性率、病变关节分布情况及超声表现结果。对患者进行2 年随访，观察患者出现急性痛风性 关节炎的阳性率。结果 经过高频关节超声检查，无症状高尿酸血症患者中发现病变关节阳性率高于对照组 （P <0.05）。无症状高尿酸血症组第一跖趾关节病变66 个，踝关节病变17 个，膝关节病变10 个。随访2 年， 各组的急性痛风性关节炎的发生率比较有差异（P <0.05）。结论 可以利用高频超声对无症状高尿酸血症患 者早期关节病变情况进行筛查，为患者开始降尿酸的时机提供更多依据，减少高尿酸血症带来的关节损害。

Abstract:

Objective To investigate the early application of high-frequency ultrasound in the screening for arthropathy in the patients with asymptomatic hyperuricemia. Methods Totally 164 patients with asymptomatic hyperuricemia and 100 healthy controls were selected. The bilateral first metatarsophalangeal joint, ankle joint and knee joint were examined by high-frequency ultrasonography. The positive rate and distribution of joint lesions and ultrasonographic manifestations were observed. The patients in the three groups were followed up for two years to observe the incidence of acute gouty arthritis. Results Totally 93 joints (9.451%) were found to have lesions under high-frequency ultrasound in the patients with asymptomatic hyperuricemia, including 66 lesions in the first metatarsophalangeal joint, 17 lesions in the ankle joint, and 10 lesions in the knee joint. The incidence of arthropathy in the patients was higher than that in the healthy controls, with statistically significant difference (P < 0.05). During the follow-up of two years, the incidence of acute gouty arthritis had statistical difference between the groups (P < 0.05). Conclusions These findings may support high-frequency ultrasound is useful to find earlystage arthropathy in patients with asymptomatic hyperuricemia, and is to help for early intervention treatment of the patients and to avoid joint damage due to hyperuricemia.