CAJ | 학술논문

目的：探讨MR征象与抗环瓜氨酸肽（CCP）抗体在早期类风湿性关节炎（RA）诊断中的价值。方法收集2013年1月至2015年4月就诊于山西医科大学附属省人民医院、第二医院患者资料，随访至明确诊断为早期RA患者32例纳入研究。收集所有病例首次双手、腕关节MRI平扫图像，共64只手、腕关节，以及扫描时间近期内抗CCP抗体实验室检查资料；分析早期RA患者的MR征象，探讨抗CCP抗体与早期RA患者MR征象的相关性。结果32例早期RA患者（共64个手、腕关节）MRI平扫异常征象包括：腕骨骨质侵蚀189处，骨髓水肿227处，腕关节积液64处，腱鞘积液58处（包括屈肌腱鞘受累36例，伸肌腱鞘受累22例，二者均受累者8例），上述征象中经Pearson相关分析结果显示，抗CCP抗体与骨质侵蚀、骨髓水肿r值分别为0.586与0.454（P<0.01），而骨质侵蚀与骨髓水肿间呈正相关，r值为0.625（P<0.01）。结论腕关节MRI对RA的早期诊断具有重要价值。骨质侵蚀、骨髓水肿征象是与抗CCP抗体一致的早期RA的表现，在早期RA诊断中有重要意义。
목적：탐토MR정상여항배과안산태（CCP）항체재조기류풍습성관절염（RA）진단중적개치。방법수집2013년1월지2015년4월취진우산서의과대학부속성인민의원、제이의원환자자료，수방지명학진단위조기RA환자32례납입연구。수집소유병례수차쌍수、완관절MRI평소도상，공64지수、완관절，이급소묘시간근기내항CCP항체실험실검사자료；분석조기RA환자적MR정상，탐토항CCP항체여조기RA환자MR정상적상관성。결과32례조기RA환자（공64개수、완관절）MRI평소이상정상포괄：완골골질침식189처，골수수종227처，완관절적액64처，건초적액58처（포괄굴기건초수루36례，신기건초수루22례，이자균수루자8례），상술정상중경Pearson상관분석결과현시，항CCP항체여골질침식、골수수종r치분별위0.586여0.454（P<0.01），이골질침식여골수수종간정정상관，r치위0.625（P<0.01）。결론완관절MRI대RA적조기진단구유중요개치。골질침식、골수수종정상시여항CCP항체일치적조기RA적표현，재조기RA진단중유중요의의。
Objective To analyze the correlation between the detection results of antibody and the result of MRI,and to explore the significance appearance of MRI for the diagnosis of early stage rheumatoid arthritis.Methods From January 2013 to April 2015,32 rheumatoid arthritis patients were collected, involved 64 wrists and hands in Shanxi People's Hospital affiliated to Shanxi Medical University and Second Hospital of Shanxi Medical University.All cases were collected for the first time, the MRI scan images of the wrist and wrist joints were collected. The CCP features of early RA patients were analyzed with 64 hands and wrists, and the MR appearances of early RA patients were analyzed.Results Many pathological changes of the early RA in 32 patients is showed by MRI, involved 64 wrists and hands .227 bone marrow edema ,189 bone destructions, 64 synovitis, 58 tenosynovitis were found in the cases. Significant correlation was between Anti-CCP antibody and bone erosion(r=0.586,P<0.01), Significant correlation was between Anti-CCP antibody and bone edema(r=0.454,P<0.01).Significant correlation was found between bone erosion score and bone edema score(r=0.625,P<0.01).Conclusion The signs of bone erosion and bone marrow edema are consistent with anti CCP antibodies in early rheumatoid arthritis. MRI findings of wrist and hand has important value in the diagnosis of early stage rheumatoid arthritis.