摘要
目的探讨高频超声诊断无症状高尿酸血症患者关节、肌腱及软组织病变的意义。方法对100例无症状高尿酸血症患者（AH组）和75例血清尿酸水平正常志愿者（对照组）行高频和彩色多普勒超声检查，观察两组膝关节、踝关节和第一跖趾关节及关节周围肌腱和软组织的情况。分析血清尿酸水平与关节软骨“双轮廓”征、骨侵蚀、关节腔积液病变程度的相关性。结果AH组和对照组膝、踝、第一跖趾关节“双轮廓”征（35、17、48个关节对0、0、0个关节）、骨侵蚀（30、25、20个关节对4、6、3个关节）、关节积液（28、36、41个关节对6、8、9个关节）、关节内点状强回声（19、18、22个关节对0、0、0个关节）差异均有统计学意义（P均〈0．05）；AH组和对照组髌腱末端病（4．5％对0．6％）、跟腱末端病（8％对O）、跟腱强回声（6％对0．6％）差异均有统计学意义（P均〈0．05）。血清尿酸水平与膝、踝、第一跖趾关节软骨“双轮廓”征、骨侵蚀、关节腔积液的病变程度无相关性（P均〉0．05）。结论肌肉骨骼超声检查可较早诊断无症状高尿酸血症患者关节、肌腱、软组织病变，部分可有关节软骨“双轮廓”征、关节内点状强回声等类似痛风性关节炎的特异性超声表现。
Objective To explore the joints and tendons characteristic features of high frequency ultrasound in asymptomatic hyperuricemia（AH） and to assess its value in AH diagnosis. Methods One hundred asymptomatic individuals with hyperurieemia （AH group） and 75 normourieemic subjects （control group） were examined by high frequency and color Doppler ultrasound. The joints, tendons and soft tissue of the knees,ankles and first metatarsal-phalangeal joints in two groups were examined. The correlations of serum urate（SU） level with double contour sign, bone erosion and articular cavity effusion were analysed. Results Hyperechoic deposition on the sulface of the articular hyaline cartilage （double contour sign） were found in the knees （35）, ankles （17） and the first metatarsophalangeal joints （ MTPJs, 48） from the asymptomatic individuals with hyperuricemia,in contrast to none in the control group （ P 〈0.05）. Similar results were found in two groups of the bone erosion （30,25,20 vs 4,6,3, P 〈0.05）,the effusion （28,36, 41 vs 6,8,9, P〈0.05） and the hyperechoic spots （19,18,22 vs 0,0,0, P〈0.05）. Patellar enthesopathy （4.50% vs 0.6%, P〈0.05） as well as achilles enthesopathy（8% vs 0, P〈0.05） and achilles tophi （6% vs 0.6%, P〈0.05） were more frequent in asymptomatic hyperuricemic than that of normouricemic individuals. No correlations between SU concentration and the presence of the double contour sign,the bone erosion and effusion were found （ P 〉0.05）. Conclusions There were some similar specific sonographic findings of gouty arthritis in the asymptomatic individuals with hyperuricemia. Also, these findings support high frequency ultrasound as a useful tool to detect anatomical damage in the joints, synovial tissue and tendons of asymptomatic individuals with hyperuricemia.
出处
《中华超声影像学杂志》
CSCD
北大核心
2014年第1期49-53,共5页
Chinese Journal of Ultrasonography
基金
福建省医学创新课题（2011-CXB-22）
关键词
超声检查
高尿酸血症
关节
腱
软组织
Ultrasonography
Hyperuricemia ~ Joints
Tendons
Soft tissue
