Prognostički značaj ultrazvučnog nalaza u proceni strukturnog oštećenja zglobova šaka i stopala kod bolesnika sa početnim reumatoidnim artritisom
Prognostic value of ultrasonogrphic findings of hands and feet joints in structural damage progression in patients with early reumathoid arthritis
Докторанд
Prodanović, Slavica Ž.Ментор
Damjanov, NemanjaЧланови комисије
Stupar-Vujasinović, NadaŠefik-Bukilica, Mirjana
Konstantinović, Vitomir
Метаподаци
Приказ свих података о дисертацијиСажетак
Dosada[nja istraživanja ukazuju na pouzdanost primene muskuloskeletnog
ultrazvuka (MSUZ) u oceni nalaza inflamacije kao i strukturnog oštećenja na
perifernim zglobovima. Cilj ovog rada je bio da se proceni strukturno oštećenje na
zglobovima šaka i stopala kod bolesnika sa dijagnozom ranog reumatoidnog artritisa
(RA) i trajanjem simptoma bolesti ≤12 meseci, primenom MSUZ i utvrditi
prognostički značaj bazalnog ultrazvučnog (UZ) nalaza nakon 6 meseci lečenja
bolesnika.
Metod. U studiju praćenja uključeno je 65 bolesnika, sa dijagnozom ranog RA
(EULAR/ACR kriterijumi iz 2010 godine), trajanja ≤12 meseci postavljenom u
ambulantnim/bolničkim uslovima Instituta za reumatologiju u Beogradu, u periodu
2012-2014. god. Uključujući kriterijumi za istraživanje bili su: 1. odsustvo predhodne
primene glikokortikoidne/DMARD terapije 2. odsustvo nalaza strukturnih promena
na urađenoj radiografiji šaka i stopala 3. odsustvo drugih inflamacijskih ili
degenerativnog oboljenja zglobova težeg stepena. Kont...rolnu grupu je činilo 30
zdravih. Na početku/ nakon 6 meseci praćenja, urađeni su: pregled sistema za
kretanje; UZ pregled zglobova šaka i stopala, prema preporukama OMERACT grupe
experata. Pregled je obavljen lineranom sondom, 8-16 MHz, aparata Esaote My Lab-
70. Nalaz inflamacije na zglobovima ocenjivan je semikvantitativno (Sckudlarek-ov
metod) a U Z n alaz erozije kvalitativno uz ocenu veličine i zapremine iste;
laboratorijski nalazi: brzina sedimentacije eritrocita (SE), C reaktivni protein (CRP),
nalaz i koncentracija reumatoidnog faktora (RF), antitela na ciklični citrulisani peptid
(ACPA) i matrixmetaloproteinaze 3 (MMP-3); radiografsko snimanje šaka i stopala;
ispitivanje funkcijskog statusa (HAQ upitnik); posle 6 meseci MR šaka. Podaci su
obrađeni u SPSS 16 sistemu...
Musculoskeletal ultrasound (MSU) is been proven clinical method in
reliable both joints inflammation and structural damage assessing. The aims of this
study were to evaluate structural damage progression of the hands and feet joints
assessed by ultrasonography (US), in patients (pts) with early, treatment naïve
rheumatoid arthritis (RA), without X-ray visible erosions, and to estimate the
prognostic value of basal ultrasound (UZ) findings after 6 months of treatment.
Method. Sixty-five pts with symptoms duration of ≤12 months and diagnosis of
early RA, according to the 2010 (ACR/EULAR) classification criteria, in Institute of
rheumatology in Belgrade, were included in a prospective clinical study during the
2012-2014 yrs.. The following including criteria had to be fulfilled 1. absence of prior
use of glycocorticoid / DMARD therapy; 2. absence of finding of structural damage
on X-ray of the hands and foot 3. absence of the others inflammatory or severe
degenerative joint‘s disorders. T...he 30 healthy control, were recruited among the staff
of the Institute. At the study entry and after 6 months of treatment, all pts. were
underwent on: clinical examination; laboratory testing (ESE, CRP, RF, ACPA, MMP-
3); radiographic and US examination which was performing by 16 MHz linear probe
of Esaote My Lab 70 high resolution machine. OMERACT US group definition was
used to detect the presence of synovial fluid and hypertrophy, PD signal, as well as
bony erosion presence, at the level of hands and feet joints. US findings was assessed
by Sckudlarek semiquantitaive method. The size and volume of erosions were rated.
After 6 months MR of hand was performed. The data were processing in SPSS
package.
Results: Complete results were obtained from 63 included pts...