【摘要】 目的研究超声是否能较血清学检查更有效发现早期类风湿关节炎(RA)兔模型的病变。方法把25只新西兰大白兔按照随机表分为2组:对照组5只,模型组20只;以卵清蛋白诱导类风湿性关节炎。以超声检测双侧膝关节的RA病变。酶联免疫吸附法检测血管内皮生长因子(VEGF)及肿瘤坏死因子-α(TNF-α)水平。在制模第4,8,12,15周,超声引导下活检,获取滑膜病理,制作病理切片,镜下观察病理改变。结果模型组,各时间点测量的超声滑膜厚度、中滑膜厚度、VEGF、TNF-α水平均高于对照组基线水平(P<0.05)。滑膜与血清学改变具有相关性。超声下,滑膜出现明显增厚,最早、最晚分别出现在关节腔注射后1,7 d;血清VEGF与TNF-α明显上升,最早出现在关节腔注射后14,35 d,最晚分别出现在造模后35,42 d。滑膜厚度出现显著增厚的时间较VEGF与TNF-α早(P<0.05)。滑膜厚度、VEGF、TNF-α结果与病理学评分的相关性分析中,滑膜厚度的相关性最高(P<0.05)。结论在初期、早期关节关节炎观察指标中,超声检查较血清学更为敏感。更多还原

【Abstract】 Objective To establish early stages of antigen induced arthritis model in rabbits and to compare the capability of early detection of arthritis between high- resolution ultrasound and serum biomarker.Methods Twenty five New Zealand white rabbits were randomized into two groups,20 in model group and 5 in control group. High- resolution ultrasound was used to evaluate arthritis on both knees. Serum vascular endothelial growth factor( VEGF) and tumornecrosis factor- α( TNF- α) level were determined by Enzyme linked immuosorbent assay. Ultrasound guided biopsy was applied and the pathological sections were observed by microscope and accessed in week 4,8,12,15 after establish model. All rabbits were sacrificed after the experiment.Results The thickness of membranes,VEGF,TNF- α in model group were significantly higher than control group( P < 0. 05). The earliest and latest membranes thickness appeared under ultrasound was on 1 and 7 d.The earliest VEGF and TNF- α increasing was on 14,35 d,the latest increasing was on 35,42 d. Membranes thickness appeared earlier than VEGF and TNF- α increasing,with significant difference( P < 0. 05).In the early stage of model group,the thickness of membranes was withhighest correlation with patholology score( P < 0. 05). Conclusion In early stage of this model,the thickness of membranes by ultrasound was more sensitive than serum biomarker.更多还原