| 徐华军1,张惠美2.第一跖趾关节痛风性关节炎与无症状高尿酸血症的超声对比分析[J].浙江中西医结合杂志,2017,27(12): |
| 第一跖趾关节痛风性关节炎与无症状高尿酸血症的超声对比分析 |
| Ultrasound Comparison of the 1MTPJ in people with gout and people with asymptomatic hyperuricaemia |
| 投稿时间：2017-02-08 修订日期：2017-09-29 |
| DOI： |
| 中文关键词: 超声 痛风 第一跖趾关节 无症状高尿酸血症 |
| 英文关键词:Ultrasound Gout MTP1 Asymptomatic hyperuricaemia |
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| 中文摘要: |
| 目的 探讨高频超声在第一跖趾关节(MTP1)痛风性关节炎与无症状高尿酸血症中的诊断与鉴别诊断价值。方法 回顾性分析2013年1月-2016年6月我院46名痛风患者和58名无症状高尿酸血症者的MTP1超声声像图,并与68名健康志愿者进行对照,观察双轨征、滑膜增厚、滑膜炎、关节腔积液、痛风石、骨侵蚀、暴风雪征等超声征象并进行对比分析。结果 与健康志愿者相比,痛风组：痛风石38例(82.61%)、双轨征17例(36.96%)、骨侵蚀32例(69.57%)、滑膜增厚28例(60.87%)、滑膜炎20例(43.48%)、关节腔积液18例(39.13%)、暴风雪征5例(10.87%),差异均有统计学意义(P＜0.05),无症状高尿酸血症组双轨征21例(36.21%)、关节腔积液28例(48.28%),差异均有统计学意义(P＜0.001)；与无症状高尿酸血症组相比,痛风组患者更易出现痛风石、骨侵蚀、滑膜增厚、滑膜炎,差异均有统计学意义(P＜0.001)。 结论 患者第一跖趾关节(MTP1)出现痛风石、双轨征、骨侵蚀、滑膜增厚、滑膜炎对于临床诊断痛风有意义,而双轨征和关节腔积液对于临床诊断无症状高尿酸血症有意义,痛风石、骨侵蚀、滑膜增厚、滑膜炎是鉴别诊断痛风与无症状高尿酸血症的相对可靠指标。 |
| 英文摘要: |
| Objective The aim of this study was to explore the value of diagnosis and differential diagnosis of the 1MTPJ in people with gout and people with asymptomatic hyperuricaemia compared with normouricaemic controls. Methods Retrospectively analysis Participants with gout (n=46), asymptomatic hyperuricaemia (n=58) and normouricaemic control participants (n=68) underwent a grey-scale and power Doppler ultrasound assessment of bilateral 1MTPJs in our hospital from January 2013 to June2016. The ultrasound images were read for the presence of the double contour sign, tophus, erosion, effusion, synovial hypertrophy, synovitis and snowstorm. Results Compared to normouricaemic control participants, participants with gout the presence of the double contour sign (n=17, 36.96%), tophus(n=38, 82.61%), erosion(n=32, 69.57%), effusion(n=18,39.13%), synovial hypertrophy(n=28,60.87%), synovitis(n=20,43.48%) and snowstorm(n=5,10.87%) , the differences were statistically significant (P﹤0.05); Compared to normouricaemic control participants, participants with asymptomatic hyperuricaemia the presence of the double contour sign (n=21, 36.21%) and effusion(n=28,48.28%) , the differences were statistically significant (P﹤0.05); Compared to asymptomatic hyperuricaemia , participants with gout had more tophus, erosion, synovial hypertrophy, synovitis, the differences were statistically significant (P﹤0.05).Conclusion Tophus, double contour sign, synovitis, synovial hypertrophy and bone erosion are common at the 1MTPJ in people with gout, all of these signs are useful for the clinical diagnose of gout, however the double contour sign and effusion are common at the 1MTPJ in people with asymptomatic hyperuricaemia. Features of tophus, erosion, synovial hypertrophy, synovitis may be useful in differentiating gout from asymptomatic hyperuricaemia. |
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