痛风性关节炎急性期、缓解期超声特征及与血清IL-22、IL-37水平的相关性研究

摘要 目的：探讨痛风性关节炎（GA）急性期、缓解期超声特征及与血清白细胞介素（IL）-22、IL-37水平的相关性。方法：选取从2019年7月至2021年3月期间,在我院诊断为GA的患者64例作为痛风组,及同期在我院体检的健康志愿者32例作为正常对照组。经过超声检查、血清样品实验后,观察受试者的超声特征,比较受试者血清IL-22、IL-37的水平,采用Spearman检验分析GA患者血清IL-22、 IL-37水平与超声特征的相关性。比较超声特征、IL-22和IL-37水平单一或联合应用对GA急性期、缓解期的诊断价值。结果：痛风组急性期血清IL-22水平显著高于缓解期及正常对照组(P＜0.05);痛风组急性期及缓解期血清IL-37水平均显著高于正常对照组,且缓解期高于急性期(P＜0.05)。64例GA患者中有29例存在痛风石;60例在急性期存在关节积液,至缓解期有22例吸收至正常积液量;有52例在急性期关节滑膜增生,至缓解期有14例得以缓解;有29例存在"双轨征",仅1例在缓解期消失;有14例发生骨侵蚀,在缓解期均未见明显改善;缓解期积液厚度、滑膜厚度均明显小于急性期(P＜0.05)。无论急性期还是缓解期,GA患者血清IL-22水平与关节积液均呈正相关(P＜0.05)。超声检查联合血清IL-22、IL-37水平检测用于诊断无论在急性期还是缓解期,其敏感性及特异性均较高。结论：IL-22水平不论在急性期还是缓解期,与超声下关节积液均呈正相关。血清IL-22、IL-37检测与超声检查联合可提高急性期及缓解期GA的诊断效能。

Study on Ultrasonic Characteristics of Gouty Arthritis in Acute Stage and Remission Stage and its Correlation with Serum IL-22 and IL-37 Levels

ABSTRACT Objective: To investigate the ultrasonic characteristics of gouty arthritis (GA) in acute stage and remission stage and its correlation with the levels of serum interleukin (IL)-22 and IL-37. Methods: From July 2019 to March 2021, 64 patients diagnosed with GA in our hospital were selected as the gout group, and 32 healthy volunteers in our hospital during the same period as the normal control group. After ultrasonic examination and serum sample test, the ultrasonic characteristics of GA patients were observed and the levels of serum IL-22 and IL-37 were compared. Spearman test was used to analyze the correlation between the levels of serum IL-22 and IL-37 and the ultrasonic characteristics of GA patients.To compare the diagnostic value of ultrasonographic features combined with levels of IL-22 and IL-37 single or combined in acute and remission stages of gout arthritis. Results: The level of IL-22 in acute stage of gout group was significantly higher than that in remission stage and normal control group (P<0.05). The level of IL-37 in gout group in acute phase and remission phase was significantly higher than that in normal control group, and the level of IL-37 in remission phase was higher than that in acute phase (P<0.05). 29 of the 64 GA patients had tophi. 60 patients had joint effusion in the acute phase, and 22 patients had joint effusion absorbed to normal levels in the remission phase. Synovial hyperplasia occurred in 52 patients in the acute phase and resolved in 14 patients in remission.There were 29 cases with dual-track syndrome, and only 1 case disappeared in remission. Bone erosion occurred in 14 cases, and no significant improvement was observed during remission. The thickness of effusion and synovium in remission phase were significantly less than that in acute phases (P<0.05). There was a significant positive correlation between IL-22 level and the degree of joint effusion in both acute and remission phase (P<0.05). The sensitivity and specificity of ultrasonography combined with serum levels of IL-22 and IL-37 were the highest in both acute and remission phase. Conclusion: The level of IL-22 was positively correlated with the joint effusion under ultrasound in both acute and remission phases. Serum levels of IL-22 and IL-37 combined with ultrasonography can improve the diagnostic performance of GA in acute and remission phases.