Rheumatology：系统性红斑狼疮患者普遍存在关节侵蚀症状

2014-12-11 王兴强丁香园

关节表现常常是系统性红斑狼疮(SLE)患者最常见和最早出现的临床症状。临床判断SLE的关节病变常应用ACR非侵蚀性关节炎的诊断标准，但SLE也有非侵蚀性变形性关节炎（Jaccoud关节）和伴关节侵蚀畸形的关节炎（Rhupus综合征）。而目前对SLE关节炎的研究却较少。为了探讨核磁共振(MRI)在SLE关节炎的诊断价值和SLE关节炎的临床特点，爱尔兰的Ball教授等做了一项病例对照研究，

关节表现常常是系统性红斑狼疮(SLE)患者最常见和最早出现的临床症状。临床判断SLE的关节病变常应用ACR非侵蚀性关节炎的诊断标准，但SLE也有非侵蚀性变形性关节炎（Jaccoud关节）和伴关节侵蚀畸形的关节炎（Rhupus综合征）。而目前对SLE关节炎的研究却较少。

为了探讨核磁共振(MRI)在SLE关节炎的诊断价值和SLE关节炎的临床特点，爱尔兰的Ball教授等做了一项病例对照研究，结果发表在近期的Rheumatology上。

该项研究选取了病程相近的34名具有关节症状的SLE患者和15名类风湿关节炎患者作为实验组和对照组。诊断分别采用1982年ACR推荐的SLE分类标准和2010年ACR/EULAR的RA分类标准。

所有患者均用Siemens Avanto1.5T磁共振扫描仪对腕关节和掌指关节行普通和增强扫描，MRI图像分别由1名影像学医师和1名风湿病医师通过OMERACT的RA评分系统评分。同时行ACPA、RF等相关实验室检查，结果采取相应统计学方法进行分析。

研究结果显示，MRI检查发现分别有93%和61%的SLE患者的腕关节和掌指关节存在关节侵蚀，这说明SLE患者普遍存在MRI可见的关节侵蚀，但ACPA阳性的患者仅占8.8%。这提示SLE患者的关节侵蚀并不依赖于ACPA水平。

93%的SLE患者至少有1个掌指关节存在不同程度的关节腔积液，而所有的SLE患者均有不同程度的腕关节骨髓水肿发生。相关分析发现，SLE患者血清抗-RA33抗体滴度与关节侵蚀评分无正相关关系，而与骨髓水肿评分呈现负相关关系。

上述结果表明，SLE患者普遍存在MRI显示的关节侵蚀，而这些患者中大部分是ACPA血清阴性的患者；SLE患者同样普遍存在不同程度的腕关节和掌指关节水肿，这可能是患者普遍存在关节疼痛的原因。

原始出处：

Ball EM1, Tan AL2, Fukuba E2, McGonagle D2, Grey A2, Steiner G2, Bell AL2, Rooney MR2.A study of erosive phenotypes in lupus arthritis using magnetic resonance imaging and anti-citrullinated protein antibody, anti-RA33 and RF autoantibody status.Rheumatology (Oxford). 2014 Oct;53(10):1835-43. doi: 10.1093/rheumatology/keu215. Epub 2014 May 20.

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2016-03-14 忠诚向上

好好学习，继续研究

123 0
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2016-03-14 忠诚向上

好好学习，继续研究

167 0
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2016-03-14 忠诚向上

好好学习，继续研究

133 0
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2016-03-14 忠诚向上

好好学习，继续研究

43 0
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2015-04-03 风铃821

#Rheumatology#

22 0
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2015-04-18 qingrejiedu

#系统性#

21 0
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2014-12-18 yayale

关注狼疮的方方面面，防患于未然

75 0
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2014-12-13 sunrural_42825357

#狼疮#

29 0

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Rheumatology：系统性红斑狼疮患者普遍存在关节侵蚀症状

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