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临床和超声波优化在类风湿性关节炎中持续缓解的患者,它可以作为一个新的优化工具吗?

Gustavo Añez¹, Vicenç Torrente-Segarra², María Bonet²

¹Rheumatology Unit, Hospital Universitari Arnau de Vilanova, Lleida, Spain. justgs@hotmail.com.

Journal of ultrasound

|October 18, 2024

概括

超声波 (US) 影像可以帮助优化类风湿性关节炎 (RA) 治疗,通过检测仅通过临床得分错过的亚临床炎症. 这项研究表明,美国减少了RA患者的疾病恶化,改善了长期的结果.

科学领域:

类风湿病学类风湿病学
医疗成像医学成像
炎症性疾病炎症性疾病

背景情况:

类风湿性关节炎 (RA) 缓解的临床评估得分可能会忽略亚临床炎症,在减少治疗期间冒着恶化风险.
超声波 (美国) 是一种可访问的成像工具,有可能补充RA管理中的临床评估.
这项研究旨在证明US的实用性,作为优化RA治疗决策的补充措施.

研究的目的:

评估超声波 (US) 在优化类风湿性关节炎 (RA) 患者治疗决策中的有用性.
评估US是否能够识别临床分数遗漏的亚临床炎症.
确定将美国药物纳入管理策略是否可以减少RA患者的疾病恶化.

主要方法:

一项多中心,盲目,随机,前性研究,涉及RA患者,符合2010年ACR/EULAR持续缓解标准.
患者被分为临床和超声组,缓解通过DAS28-ESR,CDAI/SDAI和US (关节和肌的灰度和功率多普勒) 来评估.
进行了12个月的随访,恶化是由DAS28-ESR,CDAI或SDAI得分的特定增加所定义的.

主要成果:

根据DAS28-ESR升高,18名患者经历了疾病恶化 (10个临床,8个美国组).
根据CDAI得分,有7名患者出现恶化,所有患者都在临床组.
根据SDAI得分,有8名患者出现了恶化,所有人都在临床组,这表明US可能有助于减轻这些.

结论:

超声波 (美国) 是优化类风湿性关节炎 (RA) 管理的宝贵工具.
将美国纳入评估可以减少恶化的数量,特别是在使用SDAI/CDAI指数时.
美国提供客观数据来指导治疗决策,解决纯临床评估的局限性,并可能改善长期RA患者的治疗结果.

关键词:

类风湿性关节炎类风湿性关节炎类风湿性关节炎肌肉骨超声波超声波超声波治疗优化治疗优化

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