类风湿性关节炎活动性病变MRI征象及其与FIB、FDP、D-D的相关性研究

摘要 目的：探讨类风湿性关节炎（RA）活动性病变磁共振成像（MRI）征象及其与纤维蛋白原（FIB）、纤维蛋白(原)降解产物（FDP）、D-二聚体（D-D）的相关性研究。方法：选取2020年1月-2021年2月期间我院诊治的61例RA患者，根据28个关节疾病活动指数（DAS28）评分将其分为活动组（35例）和稳定组（26例）。对比两组MRI征象，血清FIB、FDP、D-D水平。采用Spearman相关性分析RA活动期患者MRI各征象间的相关性及MRI各征象与血清FIB、FDP、D-D水平间的相关性。结果：活动组滑膜增厚或滑膜炎、骨髓水肿、软骨及骨侵蚀、腱鞘炎或周围软组织受累、关节腔积液征象人数占比均高于稳定组（P＜0.05）。活动组患者血清FIB、FDP、D-D水平均高于稳定组（P＜0.05）。Spearman相关性分析结果显示，RA活动期患者滑膜增厚或滑膜炎征象与骨髓水肿、软骨及骨侵蚀、关节腔积液征象均呈正相关（P＜0.05），骨髓水肿征象与软骨及骨侵蚀征象呈正相关（P＜0.05）；RA活动期患者滑膜增厚或滑膜炎、骨髓水肿、关节腔积液征象与血清FIB、FDP、D-D水平均呈正相关（P＜0.05），软骨及骨侵蚀征象与FIB呈正相关（P＜0.05）。结论：MRI征象可清晰显示RA患者的滑膜、骨质、关节腔及周围肌腱、软组织等异常改变，且MRI征象之间具有相关性，可在一定程度上反映RA的病理改变；血清FIB、FDP、D-D的检测有助于反映RA活动情况；MRI征象与血清FIB、FDP、D-D水平间具有相关性，二者联合应用有助于进一步评估RA活动情况。

MRI Signs of Active Lesions in Rheumatoid Arthritis and Their Correlation with FIB, FDP and D-D

ABSTRACT Objective: To explore the correlation between MRI signs of rheumatoid arthritis (RA) and fibrinogen (FIB) , fibrin degradation products (FDP), D-dimer (D-D). Methods: A total of 61 RA patients diagnosed and treated in our hospital from January 2020 to February 2021 were divided into active group (35 cases) and stable group (26 cases) according to 28 joint disease activity index (DAS28) scores.MRI signs and serum FIB, FDP and D-D levels were compared between the two groups. Spearman correlation was used to analyze the correlation between MRI signs and serum FIB, FDP and D-D levels in RA patients at active stage. Results: The proportion of patients with synovial thickening or synovitis, bone marrow edema, cartilage and bone erosion, tenosynovitis or surrounding soft tissue involvement, and articular cavity effusion in the active group was higher than that in the stable group(P<0.05). The levels of FIB, FDP and D-D in active group were higher than those in stable group(P<0.05). Spearman correlation analysis showed that signs of synovial thickening or synovitis in RA patients were positively correlated with bone marrow edema, cartilage and bone erosion, and joint cavity effusion(P<0.05), and bone marrow edema was positively correlated with cartilage and bone erosion (P<0.05). The signs of synovial thickening or synovitis, bone marrow edema and joint cavity effusion in RA patients were positively correlated with the levels of SERUM FIB, FDP and D-D(P<0.05), while the signs of cartilage and bone erosion were positively correlated with FIB(P<0.05). Conclusion: MRI findings can clearly show the abnormal changes of synovium, bone, articular cavity, surrounding tendon and soft tissue in RA patients, and MRI findings are correlated with each other, which can reflect the pathological changes of RA to a certain extent. The detection of FIB, FDP and D-D in serum was helpful to reflect RA activity. MRI signs are correlated with serum FIB, FDP and D-D levels, and their combined application is helpful to further evaluate RA activity.