摘要: |
探讨超声鉴别化脓性关节炎(SA)与幼年特发性关节炎(JIA)关节病变的临床价值。方法 回顾性分析经临床确诊的100例化脓性关节炎(SA组,共100个关节)和45例幼年特发性关节炎(JIA组,共105个关节)患儿资料,分析并比较两组超声表现;采用多因素二元Logistic回归分析筛选鉴别SA与JIA的影响因素;绘制受试者工作特征(R0C)曲线分析各超声表现单独及联合应用鉴别SA与JIA的诊断效能。结果 单因素分析显示,SA组与JIA组关节腔积液、滑膜增厚、滑膜厚度及滑膜血流分级比较,差异均有统计学意义(均P<0.05)。多因素二元Logistic回归分析显示,关节腔积液、滑膜厚度及滑膜血流分级均为鉴别SA与JIA的影响因素(均P<0.05)。ROC曲线分析显示,关节腔积液、滑膜厚度及滑膜血流分级鉴别SA与JIA的曲线下面积分别为0.781、0.935、0.910;三者联合应用鉴别SA与JIA的曲线下面积(0.972),以0.732为截断值,灵敏度为90.5%,特异度为99.0%。结论 超声在鉴别儿童SA与JIA关节病变中有一定的临床价值,联合应用多个超声表现能提高鉴别诊断效能。 |
关键词: 超声检查 化脓性关节炎 幼年特发性关节炎 回归分析 |
DOI: |
投稿时间:2023-07-19修订日期:2024-03-03 |
基金项目: |
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Clinical value of ultrasonography in differentiating joint lesions of children with suppurative arthritis and juvenile idiopathic arthritis |
nielili,cuiyingtie |
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Abstract: |
Objective To investigate the clinical value of ultrasonography in differentiating joint lesions between suppurative arthritis (SA) and juvenile idiopathic arthritis (JIA).Methods The clinical data of 100 patients with septic arthritis (SA group, 100 joints) and 45 patients with juvenile idiopathic arthritis (JIA group, 105 joints) were retrospectively analyzed. The ultrasound manifestations of the two groups were analyzed and compared.Multivariate binary Logistic regression analysis was used to screen and identify the influencing factors of SA and JIA.Receiver operating characteristic (R0C) curves were plotted to analyze the diagnostic efficacy of each ultrasound manifestation in differentiating SA from JIA alone and in combination.Results Univariate analysis showed that there were statistically significant differences in joint effusion, synovial thickening, synovial thickness and synovial blood flow classification between SA group and JIA group (all P<0.05).Multivariate binary Logistic regression analysis showed that articular effusion, synovial thickness and synovial blood flow classification were the influential factors in differentiating SA from JIA (all P<0.05).ROC curve analysis showed that the areas under the curve of articular effusion, synovial thickness and synovial blood flow classification were 0.781, 0.935 and 0.910, respectively.The area under the curve of the combined application of the three methods in the identification of SA and JIA was 0.972, with 0.732 as the cut-off value, the sensitivity was 90.5%, and the specificity was 99.0%.Conclusion Ultrasound has a certain clinical value in the differentiation of SA and JIA joint lesions in children, and the combined application of multiple ultrasound manifestations can improve the efficiency of differential diagnosis. |
Key words: Ultrasonic examination Suppurative arthritis Juvenile idiopathic arthritis Regression analysis |