超声波指甲炎预测早期牛皮关节炎的骨质侵蚀:一个纵向队列研究
Qian Zhang1, Cuilian Mao2, Fengyun Lu1
1Department of Rheumatology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China.
European journal of radiology
|February 1, 2026
概括
症状开始时的年龄较大和超声波指甲炎负担较高是早期牛皮关节炎 (PsA) 骨质侵蚀的关键预测因素. 早期超声波评估可以识别高风险患者,及时进行干预,以防止关节损伤.
科学领域:
- 类风湿病学 类风湿病学
- 医疗成像医学成像
- 临床研究 临床研究
背景情况:
- 骨质侵蚀是渐进性关节损伤和牛皮性关节炎 (PsA) 预后不佳的重要指标.
- 早期识别患有骨质侵蚀高风险的患者对于及时和积极的治疗策略至关重要,以防止不可逆转的关节损伤.
研究的目的:
- 在被诊断患有早期牛皮关节炎 (PsA) 的患者中,确定与骨质侵蚀相关的临床和超声波特征.
主要方法:
- 预期招募82名早期的PsA患者,症状持续时间在6个月以下.
- 使用修改的MASEI和DACTOS分数进行肌肉骨超声波评估,两名放射学专家证实了侵蚀.
- 后勤回归分析以确定预测诊断后2年内骨质侵蚀的变量.
主要成果:
- 患有骨质侵蚀的患者出现了晚期的疾病发作,更高的代谢综合征患病率,在基线时更多的胀关节,以及较高的DACTOS分数.
- 多变量分析显示,症状出现时的年龄较大,DACTOS分数较高是骨质侵蚀的独立预测因素.
- 在没有骨质侵蚀的患者中,在随访期间接受了较高比例的IL-17抑制剂治疗.
结论:
- 症状发病时的年龄较大和超声波上更大的甲状腺炎负担 (DACTOS评分) 是早期PsA骨质侵蚀的独立风险因素.
- 将超声波纳入早期风险分层可以帮助识别易受结构性关节损伤的患者.
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