Evaluation Of Activity Of Rheumatoid Arthritis By Seven-joint Ultrasound Scoring

Objective:The seven joint ultrasound scoring system was used to observe and evaluate the joint disease of rheumatoid arthritis,and to explore the value of US7 score in evaluating the disease activity of RA patients,so as to provide valuable information for the treatment of this kind of patients.Methods:Seven joints of 64 RA patients at different stages(active group 34 cases,static group 30 cases)and healthy control group(35 cases)were observed and graded by two-dimensional and power Doppler ultrasound.C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),28 joint disease activity scores(APS),rheumatoid factor(RF),anti-cyclic Citrulli(Anti-cyclic Citrulli)were collected in all RA patients.Nated Peptide(anti CCP antibody)and control group(ESR DAS28)were used to analyze the correlation between the results of the examination and the ultrasonic score of the seven joints.The US7 score was compared with whether the disease was active or not.The work characteristic curve of RA patients was constructed and the critical value of US7 score was determined.Result:1?There was no significant difference in age,sex and Body Mass Index(BMI)between the three groups in the active group,the stationary phase group and the control group(P > 0.05).2 ? The differences of US7 scores among the three groups were statistically significant,and the active group > the rest group > the control group(P < 0.05).There was no significant difference between the active group and the rest group(P > 0.05),and there were significant differences among the three groups in synovial membrane,bone and energy Doppler blood flow signal score(P < 0.05).All of them were active phase group > static phase group > control group(P < 0.05).3?Among the clinical indexes,there was significant difference among the threegroups in DAS28 ESR,and there was a significant difference between the active phase group,the rest phase group and the control group(P < 0.05),and compared with the rest phase group,the active phase group had significantly higher levels of CCP RF-and anti CCP antibody(P < 0.05).4?Of the US7 scores,the synovial membrane score was the highest,accounting for 50.0% of the total US7 score,while the aponeurotic sheath and bone erosion score accounted for a lower percentage of the total US7 score,which were respectively2.8%and 8.5%.The joint percentage of US7 synovium in active group was higher than that in rest group;The percentage of joints with low score was lower than that of the rest group;US7 tendon sheath of active group.The percentage of high score joints in bone was higher than that in rest group,and the percentage of joints with low score was lower than that in rest group.5?The US7 score and DAS28,ESR,CRP were positively correlated(correlation coefficient r = 0.791,0.577,0.479,P < 0.05).The synovial sheath,bone,energy Doppler blood flow score were associated with DAS28,ESR,CRP there was a positive correlation(r = 0.764,0.396,0.321,0.438,0.457,0.323,0.511,0.351,0.31 It can be seen that the correlation between US7 score and DAS28 is the strongest.6?According to the maximum Jorden index,the critical point is 42.5,that is,the US7 score ? 42.5 is judged as RA in active phase and US7 score < 42.5 as RA at rest stage.Using 42.5 as the critical point,the diagnostic sensitivity was 64.7,the specificity was 89.5.The area under receiver operating characteristic curveroc was0.801.Conclusion:1?Seven-Joint Ultrasound scoring can be used to observe the joint involvement in RA patients.2?Seven-Joint Ultrasound scoring can be used to determine whether RA patients are in active stage of disease and provide valuable information for the treatment of RA patients.