不同肌肉骨骼超声波体征、血清尿酸及其联合检测对痛风性关节炎的诊断价值

IF 1.1 4区医学 Q4 Medicine

Archives of rheumatology Pub Date : 2024-03-20 DOI:10.46497/archrheumatol.2024.10366

Jinyu Wu, Junliang Yan, Jie Chang, Chang Li, Bin Xia, Shanna Liu, Xinjian Zhu, Qingli Zhou

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引用次数: 0

摘要

研究目的本研究旨在探讨不同肌肉骨骼超声（MSUS）体征、血清尿酸（SUA）及其联合检测对痛风性关节炎（GA）的诊断价值。患者和方法在这项回顾性研究中，纳入了在 2022 年 8 月至 2023 年 3 月期间确诊为痛风性关节炎的 70 名患者（62 名男性，8 名女性；平均年龄：46.1±14.1 岁；范围：25 至 86 岁）（痛风性关节炎组）和同期确诊为类风湿性关节炎和骨关节炎的 70 名患者（54 名女性，16 名男性；平均年龄：49.0±14.1 岁；范围：21 至 75 岁）（非痛风性关节炎组）。记录两组患者的 MSUS 征兆和 SUA 阳性率，以比较差异。采用斯皮尔曼等级相关分析法分析 MSUS 征象和 SUA 与 GA 的相关性。采用接收者操作特征、曲线下面积（AUC）、敏感性、特异性和尤登指数分析不同 MSUS 征象、SUA 及其联合检测对 GA 的诊断价值。结果显示GA组双轮廓（DC）征（秩方[χ2]=102.935，P<0.001）、高回声点（χ2=56.395，P<0.001）、骨侵蚀（χ2=10.080，P<0.001）和SUA（χ2=41.117，P<0.001）的阳性率均高于非GA组。DC征阳性率（rs=0.829，p=0.001）、高回声点（rs=0.631，p<0.001）、骨侵蚀（rs=0.268，p=0.001）和SUA（rs=0.542，p<0.001）与GA呈正相关。在单一指标测量中，DC 征显示出最高的诊断价值（AUC=0.907，灵敏度=81.4%，特异性=100%，P<0.001）。在综合指标中，DC 征结合 SUA 的诊断价值最高（AUC=0.929，灵敏度=91.4%，特异性=94.3%，p<0.001），高于单独检测 DC 征。结论DC征结合SUA具有很高的诊断价值，因此可为有效、高效地诊断GA提供可靠的依据。

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Diagnostic values of different musculoskeletal ultrasound signs, serum uric acid, and their combined detection for gouty arthritis

Objectives: The study aimed to investigate the diagnostic values of different musculoskeletal ultrasound (MSUS) signs, serum uric acid (SUA), and their combined detection for gouty arthritis (GA). Patients and methods: In this retrospective study, 70 patients (62 males, 8 females; mean age: 46.1±14.1 years; range, 25 to 86 years) diagnosed with GA (the GA group) between August 2022 and March 2023 and 70 patients (54 females, 16 males; mean age: 49.0±14.1 years; range, 21 to 75 years) diagnosed with rheumatoid arthritis and osteoarthritis during the same period (the non-GA group) were included. The positive rate of MSUS signs and SUA in both groups was recorded to compare the differences. The correlations of MSUS signs and SUA with GA were analyzed using Spearman’s rank correlation analysis. The diagnostic values of different MSUS signs, SUA, and their combined detection for GA were analyzed using a receiver operating characteristic, the area under the curve (AUC), sensitivity, specificity, and the Youden index. Results: The positive rate of the double contour (DC) sign (chi-squared [χ2 ]=102.935, p<0.001), hyperechoic spots (χ2 =56.395, p<0.001), bone erosions (χ2 =10.080, p<0.001), and SUA (χ2=41.117, p<0.001) were higher in the GA group than in the non-GA group. The positive rate of the DC sign (rs=0.829, p=0.001), hyperechoic spots (rs=0.631, p<0.001), bone erosion (rs=0.268, p=0.001), and SUA (rs=0.542, p<0.001) were positively correlated with GA. Among the single-indicator measures, the DC sign exhibited the highest diagnostic value (AUC=0.907, sensitivity=81.4%, specificity=100%, p<0.001). Among the combined-indicator measures, the DC sign combined with SUA exhibited the highest diagnostic value (AUC=0.929, sensitivity=91.4%, specificity=94.3%, p<0.001), higher than DC sign detection alone. Conclusion: The DC sign combined with SUA yielded a high diagnostic value and can thus provide a reliable basis for effectively and efficiently diagnosing GA.

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来源期刊

Archives of rheumatology Medicine-Rheumatology

CiteScore

2.00

自引率

9.10%

发文量

期刊介绍： The Archives of Rheumatology is an official journal of the Turkish League Against Rheumatism (TLAR) and is published quarterly in March, June, September, and December. It publishes original work on all aspects of rheumatology and disorders of the musculoskeletal system. The priority of the Archives of Rheumatology is to publish high-quality original research articles, especially in inflammatory rheumatic disorders. In addition to research articles, brief reports, reviews, editorials, letters to the editor can also be published. It is an independent peer-reviewed international journal printed in English. Manuscripts are refereed by a "double-blind peer-reviewed" process for both referees and authors. Editorial Board of the Archives of Rheumatology works under the principles of The World Association of Medical Editors (WAME), the International Council of Medical Journal Editors (ICMJE), and Committee on Publication Ethics (COPE).