高频超声介入治疗风湿性关节炎的疗效分析

Efficacy of high-frequency ultrasound-guided interventional treatment of rheumatoid arthritis

摘要:

目的 分析高频超声介入治疗风湿性关节炎（RA）的疗效。方法 选取2017年5月—2020年6月就诊于三六三医院的96例RA患者，按随机双盲法将患者分为对照组（接受传统封闭治疗）和超声组（实施高频超声介入治疗）。对比两组关节滑膜厚度及疼痛程度、血流量分级、关节积液检出率、生化指标、炎症反应。结果 两组患者治疗前关节滑膜厚度及VAS评分比较，差异无统计学意义（P >0.05），超声组治疗后关节滑膜厚度较对照组薄，VAS评分较对照组低（P <0.05）。两组患者治疗前血流量分级比较，差异无统计学意义（P >0.05），超声组治疗后Ⅱ级、Ⅲ级血流量分级患者少于对照组（P <0.05）。两组患者治疗前超声组关节积液检出率比较，差异无统计学意义（P >0.05），超声组治疗后关节积液检出率较对照组低（P <0.05）。两组患者治疗前生化指标比较，差异无统计学意义（P >0.05），超声组治疗后生化指标水平较对照组低（P <0.05）。两组患者治疗前炎症因子水平比较，差异无统计学意义（P >0.05），超声组治疗后炎症因子水平较照组低（P <0.05）。结论 高频超声介入治疗RA疗效明显，可减轻关节病变及疼痛程度，改善滑膜内血流信号，减少炎症反应。

Abstract:

Objective To analyze the efficacy of high-frequency ultrasound-guided interventional treatment of rheumatoid arthritis (RA) and the mechanism of improvement in inflammatory response.Methods Ninety-six RA patients who were treated in our hospital from May 2017 to June 2020 were selected and divided into the traditional group (48 patients receiving intra-articular cocktail injection with 0.5 ml of 2% lidocaine hydrochloride, 0.5 ml of compound betamethasone and 0.5 ml of normal saline) and the ultrasound group (48 patients receiving high-frequency ultrasound-guided interventional treatment). The thickness of the joint synovium, degree of joint pain, grade of blood flow, incidence of joint effusion, biochemical indicators, and inflammatory response were compared between the two groups.Results The thickness of the joint synovium, Visual Analogue Scale (VAS) score, grade of blood flow, incidence of joint effusion, biochemical indicators and inflammatory response were not different between the two groups before the treatment (P >0.05). After treatment, the joint synovium was thinner and VAS score was lower in the ultrasound group compared with the traditional group (P < 0.05). The post-treatment proportion of patients with grade Ⅱ and Ⅲ blood flow and the incidence of joint effusion in the ultrasound group were also lower relative to the traditional group (P < 0.05). In addition, the levels of biochemical indicators and inflammatory factors in the ultrasound group were lower than those in the traditional group (P < 0.05).Conclusions The high-frequency ultrasound-guided interventional treatment is effective for RA, which can ameliorate the severity of the disease, relieve the pain, improve blood flow to the joint synovium, and decrease inflammatory response.