摘要
目的对膝关节骨性关节炎快速进展患者的磁共振成像(MRI)特征进行分析。方法将2015年1月至2017年12月于我院诊治的129例膝关节骨性关节炎患者纳入研究,所有患者均于入院时完善MRI检查,入院后予标准保守治疗,出院后进行2年随访,根据随访期间患者是否出现症状快速进展将患者分为进展组及无进展组,比较两组患者的一般临床资料及入院时MRI相关指标,并对患者WOMAC评分与MRI特征指标间的相关性进行分析。结果进展组患者的年龄、BMI、WOMAC评分,十字韧带退行性变、内侧/外侧半月板病理改变比例,关节积液及滑膜炎评分均明显高于无进展组(均P<0.05);多因素Logistic回归分析示高WOMAC评分(OR=1.381,95%C I:1.013~1.882,P=0.041)、关节积液评分(OR=28.914,95%CI:3.173~263.458,P=0.003)及滑膜炎评分(OR=19.132,95%CI:1.435~255.176,P=0.026)是导致膝关节骨性关节炎快速进展的独立危险因素,而无十字韧带退行性变(OR=0.246,95%CI:0.063~0.958,P=0.043)及内侧/外侧半月板病理改变(OR=0.098,95%CI:0.010~0.993,P=0.049)则是膝关节骨性关节炎快速进展的保护因素;相关性分析示WOMAC评分与关节积液评分及滑膜炎评分呈正相关(r=0.711,0.588;均P=0.000)。结论早期韧带退行变、关节腔积液、滑膜炎及半月板病理改变可能是膝关节骨性关节炎快速进展的MRI特征表现,与患者疼痛症状相关。
Objective To analyze the magnetic resonance imaging(MRI)characteristics of patients with rapid progression of knee osteoarthritis.Methods A total of 129 patients with knee osteoarthritis treated in our hospital from January 2015 to December 2017 were included in this study,all patients completed MRI examination at admission and giving the standard conservative treatment,2-year follow-up was conducted after discharge,according to whether symptoms progressed rapidly during follow-up,the patients were divided into progression group and non-progression group,the general clinical data and MRI related indicators at admission were compared between the two groups,and the correlation between WOMAC score and MRI features was analyzed.Results The age,BMI,WOMAC score,cruciate ligament degeneration,the proportion of medial/lateral meniscus pathological changes,joint effusion and synovitis score of patients in the progression group were significantly higher than those in the non-progression group(all P<0.05),the multivariate Logistic regression analysis showed that higher WOMAC score(OR=1.381,95%CI:1.013-1.882,P=0.041)and joint effusion score(OR=28.914,95%CI:3.173-263.458,P=0.003)and synovitis score(OR=19.132,95%CI:1.435-255.176,P=0.026)were independent risk factors for rapid progression of knee osteoarthritis,while no cruciate ligament degeneration(OR=0.246,95%CI:0.063-0.958,P=0.043)and pathological changes of medial/lateral meniscus(OR=0.098,95%CI:0.010-0.993,P=0.049)were protective factors for rapid progression of knee OA.The correlation analysis showed that WOMAC score was positively correlated with joint effusion score and synovitis score(r=0.711,0.588;P=0.000).Conclusions Early ligament degeneration,joint effusion,synovitis and meniscus pathological changes may be MRI features of rapid progression of knee OA,which are related to pain symptoms of patients.
作者
王珊珊
WANG Shan-shan(The army military medical university second affiliated hospital,Chongqing 400037,China)
出处
《中国CT和MRI杂志》
2022年第10期147-149,共3页
Chinese Journal of CT and MRI
