Effect of 28-joint Doppler ultrasound score on rheumatoid arthritis
XU Jun1 FU Xiaoya2 YANG Ling3 FENG Zhipeng1 TENG Shaohua1 XU Xiang1 MA Yan1 PENG Hongying1
1.Department of Nephrotic Rheumatism, the Affiliated Baiyun Hospital of Guizhou Medical University, Guizhou Province, Guiyang 550014, China;
2.Emergency Department, the First People′s Hospital of Guiyang, Guizhou Province, Guiyang 550002, China;
3.Department of Internal Medicine, Yunyan District People′s Hospital of Guiyang, Guizhou Province, Guiyang 550003, China
Abstract：Objective To investigate the value of 28-joint Doppler ultrasound was used to evaluate the clinical efficacy of different diseases modifying antirhenmatic drugs(DMARDs) in the treatment of rheumatoid arthritis (RA). Methods From June 2014 to June 2017, 45 RA patients who were admitted to Baiyun Hospital Affiliated to Guiyang Medical College and met the classification criteria of American rheumatic association/European anti-rheumatic association (ACR/EULAR) in 2010 were selected. According to the treatment regimen, the patients were divided into the Methotrexate group (Methotrexate alone), the Leflunomide group (Leflunomide combined with Methotrexate), and the Yisaipu group (tumor necrosis factor receptor-antibody fusion protein Yisaipu combined with Methotrexate), with 15 cases in each group. Doppler ultrasonography was performed on 28 joints of the three groups before and 6 months after treatment, respectively, and the observation indexes included joint effusion, synovial hyperplasia, blood flow signal in the synovial membrane and bone erosion. At the same time, rheumatoid factor (RF), anti-cyclic citrullinic peptide antibody (anti-CCP), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), 28 range of motion (DAS28) and adverse drug reactions were recorded to evaluate the clinical efficacy and safety of different DMARDs regimens in the treatment of RA. Results Before treatment, there was no significant difference in the baseline data of joint effusion, synovial hyperplasia, blood flow signal in the synovial membrane and bone erosion. DAS28 and laboratory examination between the three groups (P ＞ 0.05). After 6 months of treatment, joint effusion, synovial hyperplasia, blood flow signal in the synovial membrane and bone erosion. DAS28 and laboratory examinations (RF, CCP, CRP and ESR) of the three groups were all decreased to varying degrees compared with those before treatment, and the other indexes were compared among the three groups except bone erosion indexes, with statistically significant differences (P ＜ 0.05). The ultrasound score, DAS28 and laboratory examination indexes of Yisaipu group were the lowest, significantly lower than that of Leflunomide group and Methotrexate group (P ＜ 0.05), while Leflunomide group was also lower than that of Leflunomide group (P ＜ 0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P ＞ 0.05). Conclusion 28 joint Doppler ultrasound can provide a reliable basis for the evaluation of the clinical efficacy of different DMARDs regimens in the treatment of RA, and the efficacy of Yisaip is significantly better than Leflunomide combined with Methotrexate or using Methotrexate alone, with no obvious adverse reactions.
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2019, Vol. 16 
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