超高频术中探头评价健康中青年人群的手腕关节滑膜厚度

摘要

Objective To measure the synovial thickness in the bilateral wrist joints, metacarpophalangeal (MCP) joints and proximal interphalangeal (PIP) joints using high-resolution intraoperative ultrasound probe in healthy young and middle-aged volunteers to determine the normal reference ranges of synovial thickness in the joints. Methods This study was conducted in 100 healthy young and middle-aged volunteers, including 50 male (mean age 36.2 ± 5.0 years;range 18-54 years) and 50 female (mean age 38.8 ± 5.5 years; range 20-56 years) individuals. The synovial thickness in the bilateral wrist joints, MCP joints and PIP joints was measured using the GE Logiq S8 18 MHz polo stick-like linear probe array. Results No statistical significance was found in the synovial thickness of the wrist joints, MCP joints and PIP joints between the left and right hands, between young (<40 years) and middle-aged (≥40 years) subjects, or between the flexor surface and the extensor surface. In the male subjects, however, the synovial thickness in the wrist joints, MCP joints and PIP joints was significantly greater than that in female subjects. A significant difference was noted in the synovial thickness between the wrist joints, MCP joints and PIP joints. Conclusion Measurement of the synovial thickness of the wrist joints, MCP joints and PIP joints using high-resolution intraoperative ultrasound probe is beneficial for early diagnosis and therapy of rheumatoid arthritis.%目的：探讨超高频术中探头检查健康中青年人群双侧腕关节、掌指关节及近端指间关节的滑膜，获取手腕关节滑膜特点及正常参考值范围。方法选择100例健康中青年志愿者，其中男性50例（18~54岁，年龄36.2±5.0岁）、女性50例（20~56岁，年龄38.8±5.5岁），采用GE Logiq S818M马球棍形线阵探头观察双侧腕关节、掌指关节及近端指间关节并采用直接法测量滑膜厚度。结果研究对象双手间比较，腕关节、掌指关节及近端指间关节滑膜厚度差异无统计学意义（P>0.05）。研究对象伸面及屈面间比较，腕关节、掌指关节及近端指间关节滑膜厚度差异无统计学意义（P>0.05）。<40岁组与≥40岁组比较，腕关节、掌指关节及近端指间关节滑膜厚度差异无统计学意义（P>0.05）。男性与女性间比较，腕关节0.79±0.07 mm vs 0.65±0.08 mm、掌指关节0.59±0.06 mm vs 0.52±0.07 mm及近端指间关节0.51±0.05 mm vs 0.46±0.06 mm间滑膜厚度差异有统计学意义（P<0.05）；腕关节、掌指关节及近端指间关节间比较，其滑膜厚度差异有统计学意义（P<0.05）。结论采用高分辨率的高频探头直接法测量的健康中青年人群腕关节、掌指关节及近端指间关节滑膜厚度特点及正常参考值范围，对类风湿关节炎等疾病早期诊断及治疗具有一定的指导意义。