[1]龚晶晶,兰 英,王美霞,等.肌骨超声对首发痛风与无症状高尿酸血症鉴别诊断及临床特点的研究[J].医学信息,2024,37(23):62-65.[doi:10.3969/j.issn.1006-1959.2024.23.014]
　GONG Jingjing,LAN Ying,WANG Meixia,et al.Study of Musculoskeletal Ultrasound in the Differential Diagnosis and Clinical Characteristics of First-episode Gout and Asymptomatic Hyperuricemia[J].Journal of Medical Information,2024,37(23):62-65.[doi:10.3969/j.issn.1006-1959.2024.23.014]
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肌骨超声对首发痛风与无症状高尿酸血症鉴别诊断及临床特点的研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年23期
页码:
62-65
栏目:
论著
出版日期:
2024-12-01

文章信息/Info

Title:
Study of Musculoskeletal Ultrasound in the Differential Diagnosis and Clinical Characteristics of First-episode Gout and Asymptomatic Hyperuricemia
文章编号:
1006-1959（2024）23-0062-04
作者:
龚晶晶1; 兰 英1; 王美霞2; 程祥勇1; 辛华博1; 谢芳玲1
联勤保障部队庐山康复疗养中心/九江171医院特诊科1，内分泌2，江西 九江 332000
Author(s):
GONG Jingjing1; LAN Ying1; WANG Meixia2; CHENG Xiangyong1; XIN Huabo1; XIE Fangling1
Department of Special Clinic1,Department of Endocrinology2,Joint Logistic Support Force Lushan Rehabilitation and Nursing Center/Jiujiang 171 Hospital,Jiujiang 332000,Jiangxi,China
关键词:
肌骨超声; 首发痛风; 无症状高尿酸血症; 鉴别诊断
Keywords:
Musculoskeletal ultrasound; First-episode gout; Asymptomatic hyperuricemia; Differential diagnosis
分类号:
R445.1
DOI:
10.3969/j.issn.1006-1959.2024.23.014
文献标志码:
A
摘要:
目的 探讨肌骨超声在首发痛风与无症状高尿酸血症鉴别诊断中的应用及临床特点。方法 选取联勤保障部队庐山康复疗养中心2022年6月-2023年12月收治的首发痛风与无症状高尿酸血症住院及门诊军队患者100例作为研究组，选取同期医院健康体检正常的军队人员100例作为对照组。以临床综合诊断作为金标准，评价肌骨超声诊断价值；并分析研究组患者临床特点，另采用多因素非条件性Logistic回归分析首发痛风、无症状高尿酸血症患者发病的危险因素。结果 研究组100例患者均采用肌骨超声检查，阳性检出48例，灵敏度为90.20%（46/51）、特异度为95.92%（47/49）、准确度为93.00%（93/100）、阳性预测值为95.83%（46/48）、阴性预测值为90.38%（47/52）；Kappa检验显示，肌骨超声与金标准诊断一致性极好（Kappa=0.818）。研究组骨侵蚀、关节腔积液、软组织肿胀、滑膜增厚、双轨征、滑膜内痛风石6个特征声像图发生率高于对照组（P＜0.05）。多因素非条件性Logistic回归分析显示，无症状高尿酸血症患者双轨征、痛风石是发病的影响因素（P＜0.05）；首发痛风患者骨侵蚀、关节腔积液、软组织肿胀、滑膜增厚、双轨征、滑膜内痛风石6个特征声像图均为发病的危险因素（P＜0.05）。结论 首发痛风与无症状高尿酸血症的超声征象具有一定差异,且肌骨超声在二者诊断及鉴别诊断上具有较好价值。
Abstract:
Objective To investigate the application and clinical characteristics of musculoskeletal ultrasound in the differential diagnosis of first-episode gout and asymptomatic hyperuricemia.Methods A total of 100 hospitalized and outpatient military patients with first-episode gout and asymptomatic hyperuricemia admitted to Joint Logistic Support Force Lushan Rehabilitation and Nursing Center from June 2022 to December 2023 were selected as the study group, and 100 military personnel with normal physical examination in the hospital during the same period were selected as the control group. The diagnostic value of musculoskeletal ultrasound was evaluated with clinical comprehensive diagnosis as the gold standard, the clinical characteristics of the patients in the study group were analyzed, and the risk factors of the onset of gout and asymptomatic hyperuricemia were analyzed by multivariate unconditional Logistic regression.Results All the 100 patients in the study group were examined by musculoskeletal ultrasound, and 48 patients were positive, the sensitivity was 90.20% (46/51), the specificity was 95.92% (47/49), the accuracy was 93.00% (93/100), the positive predictive value was 95.83% (46/48), and the negative predictive value was 90.38% (47/52). Kappa test showed that the consistency between musculoskeletal ultrasound and gold standard diagnosis was excellent (Kappa =0.818). The incidence of bone erosion, joint cavity effusion, soft tissue swelling, synovial thickening, double track sign and tophi in synovium in the study group was higher than that in the control group (P<0.05). Multivariate unconditional logistic regression analysis showed that double-track sign and tophi were the influencing factors of the incidence of asymptomatic hyperuricemia (P<0.05); the six characteristic sonograms of bone erosion, joint cavity effusion, soft tissue swelling, synovial thickening, double-track sign and tophi in synovium were all risk factors for the onset of gout (P<0.05).Conclusion There are some differences in ultrasonic signs between first-episode gout and asymptomatic hyperuricemia, and musculoskeletal ultrasound has good value in the diagnosis and differential diagnosis of the two.

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更新日期/Last Update: 1900-01-01