目的:本研究旨在使用超声(US)评估强直性脊柱炎(AS)患者的周围部位和前胸壁(ACW),并研究疾病活动度与US评分之间的相关性。
方法:这项前瞻性横断面研究包括104名AS患者和50名对照受试者。每位患者接受了23例ACW和11个部位的US扫描。美国的特点,包括低回声,厚度,侵蚀,钙化,滑囊炎,和多普勒信号,进行了评估。基于C反应蛋白(CRP)评估疾病活动性,红细胞沉降率(ESR),疾病活动评分-C反应蛋白(ASDAS-CRP),和巴斯强直性脊柱炎疾病活动指数(BASDAI)。
结果:美国最常见的是跟腱(AT)和股四头肌腱(QT)。ACW最累及的部位是胸锁关节(SCJ)。与对照组相比,在AS组中,US附着点炎和ACW的发生率存在显着差异(P=0.01),SCJ(P=.00),和肋软骨关节(CCJ)(P=0.01)。具有高或非常高疾病活动度的患者具有较高的侵蚀评分(P=.02)。侵蚀评分与CRP呈微弱正相关,ESR,BASDAI,ASDAS-CRP,和ASDAS-ESR(相关系数:0.22-0.45)。
结论:美国最常见的发病部位是AT和QT,而ACW的部位是SCJ。美国对AS的评估应考虑ACW。高疾病活动性可能表明AS的侵蚀。
OBJECTIVE: The study was designed to evaluate entheseal sites and anterior chest wall (ACW) of patients with ankylosing spondylitis (AS) using ultrasound (US) and investigate the correlation between disease activity and US score.
METHODS: This prospective cross-sectional study included 104 patients with AS and 50 control subjects. Each patient underwent US scanning of 23 entheses and 11 sites of the ACW. The US features, including hypoechogenicity, thickness, erosion, calcification, bursitis, and Doppler signal, were evaluated. Disease activity was assessed based on C reactive protein (CRP), erythrocyte sedimentation rate (ESR), disease activity score-C reactive protein (ASDAS-CRP), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).
RESULTS: The most commonly involved entheses on US were the Achilles tendon (AT) and quadriceps tendon (QT). The most involved site of ACW was the sternoclavicular joint (SCJ). Compared with the control group, significant differences were observed in the AS group in the rates of US enthesitis and ACW in AT (P = .01), SCJ (P = .00), and costochondral joint (CCJ) (P = .01). Patients with high or very high disease activity had a higher erosion score (P = .02). The erosion score was weakly positively associated with CRP, ESR, BASDAI, ASDAS-CRP, and ASDAS-ESR (correlation coefficient: 0.22-0.45).
CONCLUSIONS: The most commonly involved entheseal sites on US were AT and QT, while the site of ACW was SCJ. The US assessment of AS should take the ACW into account. High disease activity might indicate erosion in AS.