彩色多普勒超声评价血友病患者早期关节病变的应用价值

摘要

Objective:To investigate the clinical values and manifestations of early joint lesion in patients with hemophilia by using the ultrasonographic.Methods:Forty-seven patients were diagnosed with moderate to severe hemophilia on the knee,elbow and ankle joints on color Doppler ultrasonography image.The joint ultrasound characteristics were scored with HEADUS scoring system and graded according to level of the synoval blood flow.Results:Synovial hyperplasia was found in 21.7％ (60/277) of the joints,cartilage destruction was showed in 9.4％(26/277) of the joints and bone destruction was displayed in 10.1％(28/277) of the joints.The correlation between HEAD-US score,synovial hyperplasia,synovial blood flow and the number of bleedings within half year and total number of bleeding is positive.Conclusion:Ultrasound can find many early joint lesions in hemophilia patient,it is hopeful to be a feasible and reliable tool to evaluate the early joint disease of hemophilia and guide individual treatment.%目的:探讨血友病患者早期关节病变的超声表现及临床应用价值.方法:超声观察47名确诊为血友病患者的双肘、双膝、双踝关节,按照HEAD-US方法评分并观察滑膜血流情况并分级.结果:21.7％ (60/277)的关节发现了滑膜增生,9.4％(26/277)的关节发现了软骨破坏,10.1％(28/277)的关节发现了骨破坏,HEAD-US评分、滑膜增生及滑膜血流分级均与半年内出血次数及总出血次数呈正相关.结论:超声能发现多种血友病患者早期关节病变,有望为临床评估关节病变程度、指导个体化治疗提供帮助.