类风湿性关节炎肩关节病变的影像学测量Radiographic findings of the shoulder in patients with rheumatoid arthritis
何勇;胡军林;顾湘杰;欧阳桂林;肖涟波;夏卿;黄正;韩大鹏;朱飞;孙松涛;
摘要(Abstract):
[目的]调查类风湿性关节炎(rheumatoid arthritis,RA)患者的肩关节功能及影像学改变,了解该类人群中肩关节病变现状,分析肩关节破坏的相关因素,为RA肩部疾病的预防和治疗提供临床依据。[方法]随机选择RA患者,记录发病年龄、病程,采用ASES肩关节评分量表评测肩关节功能;拍摄肩关节正位X线片,进行Larson分期,测量肩关节内侧距离(MD)、肩关节上移指数(UI)、肩关节內移指数(MI)、大结节关节面间距(GA),分析Larson分期与上述数据间的相关性。[结果]2010年3月~2010年11月,60人入选本研究,平均年龄(51.34±14.14)岁,男6人,女54人。ASES评分(72.69±24.76)分;完成116肩摄X线片,无明显骨性破坏的肩关节(Larson 0~1期)MD为(7.55±0.55)cm,UI为1.38±0.10,MI为1.04±0.29,GA为(0.60±0.22)cm。Larson分期与ASES评分呈显著负相关(r=-0.028 3,P=0.001),与反映肩关节内移的MD、MI呈显著负相关(r=-0.177,P=0.029和r=-0.438,P<0.001);与UI无显著相关性(r=-0.062,P=0.253);与GA呈显著负相关(r=-0.369,P<0.001)。与病程和年龄呈显著正相关(r=0.534和r=0.390,P<0.001),与患病年龄无显著相关性(r=0.091,P=0.165)。[结论]肩关节受累在RA患者中广泛存在,其受累程度随着病程增加而增加,随着破坏程度的加剧肩关节旋转中心发生内移,但是尚不明确旋转中心上移与骨性破坏是否同步发展。
关键词(KeyWords): 类风湿性关节炎;肩关节;影像学测量
基金项目(Foundation):
作者(Author): 何勇;胡军林;顾湘杰;欧阳桂林;肖涟波;夏卿;黄正;韩大鹏;朱飞;孙松涛;
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参考文献(References):
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