关键词: 类风湿关节炎, 超声检查, 28关节疾病活动评分, 关节肿胀

Abstract: Objective　To evaluate the sensitivity and consistency between ultrasound disease activity score in 28 joints（US-DAS28） and DAS28 score in the assessment of disease activity in patients with rheumatoid arthritis（RA）．Methods　127 RA patients receiving outpatient or inpatient care from Department of TCM Rheumatology，China-Japan Friendship Hospital from January 2013 to July 2017 were recruited.Their 28 joints，including proximal interphalangeal joints，metacarpophalangeal joints，wrist joints，elbow joints，shoulder joints and knee joints，were checked.DAS28 score was calculated based on the number of tender and swollen joints identified by clinical examination，patient self-assessment of general joint status and C-reactive protein（CRP） level.And US-DAS28 score was calculated in accordance with the number of swollen joints identified by gray-scale ultrasound.Results　The average number of swollen joints identified by clinical examination was less than that found by ultrasound〔2.0（0，4.0）vs.5.0（2.0，8.0）〕（Z=-7.783，P<0.001）．Moreover，DAS28 score was lower than US-DAS28 score〔（3.43±1.18） vs.（3.69±1.03）〕（tpaired= -9.668，P<0.001）．Pearson correlation analysis showed that there was a positive correlation between DAS28 score and US-DAS28 score（r=0.968，P<0.001）．The degree of disease activity assessed by US-DAS28 score was more serious than that by DAS28 score（Z=-4.680，P<0.001）．Conclusion　There is a good consistency between US-DAS28 and DAS28 score for assessing RA disease activity，but US-DAS28 score has a higher sensitivity，so it can provide an aid for clinical treatment.

Key words: Rheumatoid arthritis, Ultrasonography, Disease activity score in 28 joints, Joint swelling