摘要
目的:应用双能CT成像技术分析痛风患者尿酸钠盐沉积量,探讨尿酸钠盐沉积量对难治性痛风(refractory gout,RG)发生的预测价值。方法:回顾性分析2023年3月至2025年6月收治的176例痛风患者的基本资料,男171例,女5例;年龄22~71(43.16±10.82)岁。根据诊断标准分为RG组和非RG组。RG组92例,男90例,女2例,年龄24~66(44.62±11.12)岁;非RG组84例,其中男81例,女3例,年龄22~71(41.46±10.31)岁。比较两组高尿酸血症病程、尿酸和尿酸钠(monosodium urate,MSU)沉积量。采用多元Logistic回归分析RG的影响因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,并计算ROC曲线下面积(area under the curve,AUC),评估MSU沉积量对RG的预测价值。结果:两组合并高血压、高尿酸血症病程和MSU沉积量比较,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,MSU沉积量[OR=5.402,95%CI(2.095,13.933),P<0.01]、高血压[OR=2.724,95%CI(1.209,6.134),P<0.05]、高尿酸血症病程[OR=1.122,95%CI(1.032,1.219),P<0.01]均为RG的独立危险因素。MSU沉积量预测RG的AUC为0.824[95%CI(0.763,0.885),P<0.01],灵敏度为63%,特异度为92.9%,最佳截断值为0.410 cm3。结论:MSU沉积量可增加RG的发生风险,关节腔内MSU沉积量可为早期识别RG提供参考。
Objective To analyze deposition of sodium urate in patients with gout,and to explore predictive value of sodium urate deposition for the occurrence of refractory gout(RG)by dual-energy CT imaging technique.Methods A retrospective analysis was conducted on basic data of 176 gout patients admitted from March 2023 to June 2025,including 171 males and 5 females,aged from 22 to 71 years old with an average of(43.16±10.82)years old.According to diagnostic criteria,the patients were divided into RG group and non-RG group.There were 92 patients in RG group,including 90 males and 2 females,aged from 24 to 66 years old with an average of(44.62±11.12)years old;there were 84 patients in non-RG group,including 81 males and 3 females,aged from 22 to 71 years old with an average of(41.46±10.31)years old.The courses of hyperuricemia,uric acid and deposition amounts of monosodium urate(MSU)between two groups were compared.Multivariate Logistic regression was used to analyze influencing factors of RG,receiver operating curve(ROC)was plotted,and area under the curve(AUC)was calculated,in order to evaluate predictive value of MSU deposition for RG.Results The courses of hypertension and hyperuricemia and deposition amount of MSU between two groups were statistically significant(P<0.05).Logistic analysis reault showed intra-articular MSU deposition[OR=5.402,95%CI(2.095,13.933),P<0.01],hypertension[OR=2.724,95%CI(1.209,6.134),P<0.05],courses of hyperuricemia[OR=1.122,95%CI(1.032,1.219),P<0.01]were independent risk factors for RG.AUC of MSU deposition for predicting RG was 0.824[95%CI(0.763,0.885),P<0.01],and sensitivity was 63%,specificity was 92.9%,and the optimal cut-off value was 0.410 cm3.Conclusion MSU deposition could increase risk of RG,and the amount of MSU deposition in joint cavity could provide a reference for early identification of patients with RG.
作者
谢存香
梅建
侯晓莹
方锦颖
黄怡迪
黄健
叶冠成
王浩
王海隆
XIE Cun-xiang;MEI Jian;HOU Xiao-ying;FANG Jin-ying;HUANG Yi-di;HUANG Jian;YE Guan-cheng;WANG Hao;WANG Hai-long(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《中国骨伤》
2025年第12期1210-1214,共5页
China Journal of Orthopaedics and Traumatology
基金
国家重点研发计划项目(编号:2022YFC3501200,2022YFC3501203)
国家自然科学基金项目(编号:8237142950)。
关键词
痛风
难治性痛风
双能CT
尿酸钠沉积量
Gout
Refractory gout
Dual-energy CT
Monosodium urate deposition
