中文摘要：

目的通过肌骨超声评估类风湿关节炎（RA）患者关节受累情况，探讨肌骨超声半定量评价与类风湿关节炎自身抗体、实验室指标、临床评估的相关性，探索类风湿关节炎新的评价体系，完善类风湿关节炎患者的个体化治疗模式。方法纳入2014年2月至2015年2月间在四川大学华西医院风湿免疫科病房住院的RA患者共30例，用肌骨超声对患者的双手、双腕、双膝的关节分别从关节积液、滑膜增生、腱鞘炎、骨侵蚀四个方面进行扫查和评估，记录超声半定量评价分数。对采集的数据进行分析和比较。结果在30例RA患者中，合并关节痛20名（66．7％），不伴关节痛的患者有10名（33．3％）。统计结果显示RA患者受累关节的频率从大到小分别是腕关节、掌指关节（MCP）FMCP2〉MCP5〉MCPI〉MCP3〉MCP4]、近端指间关节（PIP）[PIP2〉PIP3〉PIPI〉PIP5〉PIP4]、膝关节。RA患者的肌骨超声评分与炎性指标（血沉、C反应蛋白）、自身抗体（RF、CCP）、DA$28评分以及IL-6水平相关（P〈0．01）。结论肌骨超声作为评估和预测患者关节和肌腱受累的有力工具，具有安全、无创、廉价、接受度高等优点，是风湿性疾病的重要诊疗手段之一。肌骨超声对于评估RA患者的亚临床滑膜炎的敏感度高，其评分与RA患者的自身抗体、血白介素6水平、DAS28评分呈正相关。以肌骨超声做为基础，我们的研究离探索出新的关节炎的评价体系更近了一步。

英文摘要：

Objective To evaluate the joint involvement in Rheumatoid arthritis（RA） through musculoskeletal ultrasound（MSUS）, analyze the relationship between ultrasound assessment and autoantibodies, inflammatory biomarkers and clinical scoring system, explore the evaluation system for lupus arthritis and consummate the individual treatment strategy for RA. Methods 30 patients with RA （7 male patients, 21 female patients） was included in February 2014 to February 2015 in Rheumatology Department, West China Hospital, Sichuan University. We used MSUS to evaluate the hands, wrists and knees from four aspects （joint effusion, synovial hyperplasia, tenosynovitis, bone erosion） respectively and recorded ultrasonic semi-quantitative evaluation scores. All of the datas were collected for analysis and comparising. Results In 30 RA patients, there were 20 cases with painful joints （66.7%） and 10 cases without painful joints （33.3%）. In assessments of 420 joints, the frequency of involvement from high to low was wrist, MCP（MCP2〉MCP5 〉MCPI〉MCP3〉MCP4）, PIP（PIP2〉PIP3〉PIP1〉PIP5〉PIP4） and knee. We analyze the correlation between the semi-quantitative evaluation of MSUS and autoantibodies, laboratory data, the clinical score. We have found MSUS scores and inflammatory indexes （blood sedimentation, c-reactive protein）, DAS28 ratings, the level of IL - 6 are signifi- cantly correlated in RA patients. （P〈0.01）. Conclusion Musculoskeletal ultrasound is a powerful tool to evaluate and predict the affected joints and tendons. MSUS is one of the important diagnostic methods of the rheumatic diseases with safe, noninvasive, cheap, and highly acceptance. Musculoskeletal ultrasound is highly sensitive to evaluate the RA patients with subclinical synovitis. The MSUS scores of patients are positively correlated with RA autoantibodies, the level of interleukin 6 and DAS28 scores. Our study proved the value of new evaluation system of arthritis by musculoskeletal ultrasound.