Monosodium urate crystal deposition associated with the progress of radiographic grade at the sacroiliac joint in axial SpA: a dual-energy CT study.
Monosodium urate crystal deposition associated with the progress of radiographic grade at the sacroiliac joint in axial SpA: a dual-energy CT study.
复制标题
尿酸钠晶体沉积与中轴 SpA 骶髂关节放射学分级进展相关：双能 CT 研究
DOI：
10.1186/s13075-017-1286-0
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发表时间：
2017-05-02
影响因子：
4.9
通讯作者：
Li J
中科院分区：
文献类型：
--
作者：
Zhu J;Li A;Jia E;Zhou Y;Xu J;Chen S;Huang Y;Xiao X;Li J
先前的研究表明，强直性脊柱炎（AS）作为中轴性脊柱关节炎（AxSpA）的起源，其特征是骶髂关节炎和脊柱炎的隐性进行性。双能计算机断层扫描（DECT）最近被用于分析尿酸单钠（MSU）晶体的沉积，具有更高的灵敏度和特异性。然而，目前尚不清楚AxSpA患者骶髂关节处DECT检测到的MSU晶体沉积的存在是否也与现有的结构损伤相关。在这里，我们进行了这项研究，以显示DECT MSU晶体沉积在AxSpA患者没有并存的痛风，并确定MSU晶体沉积和骶髂关节的结构性关节损伤之间的关系。招募了186名没有同时存在痛风的AxSpA患者。获得骶髂关节的平片，沿着进行骨盆的DECT扫描和临床变量。所有基于左侧或右侧骶髂关节损伤分级（0-4）的统计数据均独立计算。对骶髂关节的临床特征和影像学分级进行双变量分析和有序logistic回归。AxSpA患者的骨盆部可见大量MSU结晶沉积。左侧骶髂关节、右侧骶髂关节和骨盆的平均MSU晶体体积分别为0.902 ± 1.345、1.074 ± 1.878和5.272 ± 9.044 cm 3，这些值与血清尿酸浓度相关（r = 0.727、0.740、0.896; p < 0.001）。在双变量分析中，广泛的临床变量与骶髂关节损伤的变化相关。此外，AxSpA持续时间、BASFI评分和骶髂关节两侧MSU晶体体积在有序logistic模型中与骶髂关节放射学分级进展相关（左侧AOR = 1.180，3.800，1.920;右侧AOR = 1.190，3.034，1.418; p < 0.01）。无痛风病史的AxSpA患者在骨盆部发现大量MSU结晶沉积。除了AxSpA持续时间和BASFI评分外，骶髂关节处的MSU晶体沉积与这些患者骶髂关节的放射学分级进展相关。
Previous studies have revealed that ankylosing spondylitis (AS), as the progenitor of axial spondyloarthritis (AxSpA), has been characterized by the insidiously progressive nature of sacroiliitis and spondylitis. Dual-energy computed tomography (DECT) has recently been used to analyse the deposition of monosodium urate (MSU) crystals with higher sensitivity and specificity. However, it remains unclear whether the existence of the MSU crystal deposition detected by DECT at the sacroiliac joint in patients with AxSpA also is associated with the existing structural damage. Here, we performed this study to show the DECT MSU crystal deposits in AxSpA patients without coexisting gout and to ascertain the relationship between the MSU crystal deposition and the structural joint damage of sacroiliac joints. One hundred and eighty-six AxSpA patients without coexisting gout were recruited. The plain radiographs of the sacroiliac joint were obtained, along with the DECT scans at the pelvis and the clinical variables. All statistics based on the left or right sacroiliac joint damage grading (0–4) were calculated independently. Bivariate analysis and ordinal logistic regression was performed between the clinical features and radiographic grades at the sacroiliac joint. At the pelvis, large quantities of MSU crystal deposition were found in patients with AxSpA. The average MSU crystal volume at the left sacroiliac joint, the right sacroiliac joint, and the pelvis were 0.902 ± 1.345, 1.074 ± 1.878, and 5.272 ± 9.044 cm3, values which were correlated with serum uric acid concentrations (r = 0.727, 0.740, 0.896; p < 0.001). In bivariate analysis, wide clinical variables were associated with the changes in sacroiliac joint damage. Further, the AxSpA duration, BASFI score, and the volume of MSU crystal at both sides of sacroiliac joint were associated with the progress of radiographic grade at the sacroiliac joints in the ordinal logistic models (left AOR = 1.180, 3.800, 1.920; right AOR = 1.190, 3.034, 1.418; p < 0.01). Large quantities of MSU crystal deposition detected by DECT were found at the pelvis in AxSpA patients without coexisting gout. In addition to AxSpA duration and BASFI score, the MSU crystal deposition at the sacroiliac joint is associated with the progress of radiographic grade at sacroiliac joints in those patients.