Value Of High-frequency Color Doppler Ultrasound To ’Treat To Target’ For Rheumatoid Arthritis

Objective: High-frequency color doppler ultrasound to assess ultrasound changes in patients with rheumatoid arthritis(RA)das28 high disease activity during standard treatment,and to explore the significance of high frequency color doppler ultrasound evaluation in RA standard treatment evaluation.Methods:we retrospectively selected 88 patients with high disease activity RA after treatment evaluation DAS28 score up to standard or low disease activity between2015-01 and 2018-08 in our hospital.we compared the ultrasound test evaluation,DAS28 score and other clinical indicators before and after treatment up to standard.Results:1.88 RA patients had high disease activity before treatment,54 patients reached the standard remission period after treatment,and 34 patients with low disease activity.the hemoglobin,D-D polymer,erythrocyte sedimentation rate,C-reactive protein,rheumatoid factor(RF),and DAS28 scores were improved before and after treat to target treatment.The ultrasound scores of wrist,knuckles and knee joints were improved before and after the treat to target treatment,the difference was statistically significant(P<0.05).2.The ultrasound scores of wrist,knuckles and knee joints were improved before and after the treat to target treatment of RA patients,and the difference was statistically significant(P<0.05).There was no significant difference in the improvement rate between wrist and knuckles facet ultrasound scores.There was no significant difference in the improvement rate of ultrasound score between knee joint and knuckles joint.there was no significant difference in the improvement rate between wrist and knee ultrasound scores.Both wrist joint,knuckles facet joint,knee joint ultrasound improvement rate were less than DAS28 improvement rate,the difference was statistically significant(P<0.05).3.In serological indicators,patients with positive anti-cycloaminopeptide antibody(anti-CCP)improved the joint cavityeffusion,Blood flow signal and DAS28 score before and after treat to target treatment,the difference was statistically significant(P<0.05);patients with anti-CCP had no significant difference in synovial thickness before and after treatment.the number of joints with bone erosion in patients with anti-CCP positive was larger than that of antiCCP negative before and after treat to target treatment(P<0.05).The synovial thickness,joint cavity effusion and blood flow signal of knee joint were significantly improved before and after treat to target treatment in RF negative patients(P<0.05).while RF weak positive patients before and after the treat to target treatment,knee joint cavity effusion,synovial thickness significantly improved,the difference was statistically significant(P<0.05).Improvement of articular cavity effusion,synovial thickness and blood flow signal was statistically significant(P<0.05)before and after treatment with RF strong positive patients.The proportion of bone erosion increased before and after treat to targettreatment in RF negative patients,and the difference was statistically significant(P<0.05).4.RA patients with short course of disease had improved synovial thickness and DAS28 score before and after treat to target treatment,and the difference was statistically significant(P<0.05).Patients with long course of rheumatoid arthritis had improved articular cavity effusion,DAS28 score and ultrasound score before and after treatment,and the difference was statistically significant(P<0.05).patients with long course of disease before and after treatment,the proportion of blood flow signal was smaller than that of patients with short course of disease,and the difference was statistically significant(P<0.05).Conclusion:RA patients with high disease activity can reach the standard remission stage or low disease activity after standard treatment,and joint ultrasound can be improved;the proportion of bone erosion before and after standard treatment in patients with CCP positive RA is larger than that in patients with negative disease,and the bone destruction in patients with positive anti-body is more serious than that in negative patients.No matter serological diagnostic index anti-CCP antibody and RF negative or positive,long or short course of disease,RA improvement of ultrasound score standard treatment suggested that there is still bone destruction.RA use of high frequency colordoppler to evaluate joints is not completely consistent with the use of DAS28 evaluation,the improvement rate of high frequency color doppler is less than the improvement rate of DAS28 score,and the combination of the two can better evaluate RA disease activity.