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血友病性关节病HEAD-US半定量超声评估量表的临床应用及优化探索
OBJECTIVE: To assess the feasibility of HEAD-US scale in the clinical application of hemophilic arthropathy (HA) and propose an optimized ultrasound scoring system. METHODS: From July 2015 to August 2017, 1 035 joints ultrasonographic examinations were performed in 91 patients. Melchiorre, HEAD-US (...
Formato: | Online Artículo Texto |
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Lenguaje: | English |
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Editorial office of Chinese Journal of Hematology
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342577/ https://www.ncbi.nlm.nih.gov/pubmed/29562448 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2018.02.011 |
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collection | PubMed |
description | OBJECTIVE: To assess the feasibility of HEAD-US scale in the clinical application of hemophilic arthropathy (HA) and propose an optimized ultrasound scoring system. METHODS: From July 2015 to August 2017, 1 035 joints ultrasonographic examinations were performed in 91 patients. Melchiorre, HEAD-US (Hemophilic Early Arthropathy Detection with UltraSound) and HEAD-US-C (HEAD-US in China) scale scores were used respectively to analyze the results. The correlations between three ultrasound scales and Hemophilia Joint Health Scores (HJHS) were evaluated. The sensitivity differences of the above Ultrasonic scoring systems in evaluation of HA were compared. RESULTS: All the 91 patients were male, with median age of 16 (4–55) years old, including 86 cases of hemophilia A and 5 cases hemophilia B. The median (P(25), P(75)) of Melchiorre, HEAD-US and HEAD-US-C scores of 1 035 joints were 2(0,6), 1(0,5) and 2(0,6), respectively, and the correlation coefficients compared with HJHS was 0.747, 0.762 and 0.765 respectively, with statistical significance (P<0.001). The positive rates of Melchiorre, HEAD-US-C and HEAD-US scale score were 63.0% (95%CI 59.7%–65.9%), 59.5% (95%CI 56.5%–62.4%) and 56.6% (95%CI 53.6%–59.6%) respectively, and the difference was statistically significant (P<0.001). Even for 336 cases of asymptomatic joints, the positive rates of Melchiorre, HEAD-US-C and HEAD-US scale score were 25.0% (95%CI 20.6%–29.6%), 17.0% (95%CI 12.6%–21.1%) and 11.9% (95%CI 8.4%–15.7%) respectively, and the difference was statistically significant (P<0.001). There were significant changes (P<0.05) in the ultrasonographic score of HA before and after onset of hemorrhage in 107 joints of 40 patients. The difference in variation amplitude of HEAD-US-C scores and HEAD-US scores before and after joint bleeding was statistically significant (P<0.001). CONCLUSION: Compared with Melchiorre, there were similar good correlations between HEAD-US, HEAD-US-C and HJHS. HEAD-US ultrasound scoring system is quick, convenient and simple to use. The optimized HEAD-US-C scale score is more sensitive than HEAD-US, especially for patients with HA who have subclinical state, which make up for insufficiency of sensitivity in HEAD-US scoring system |
format | Online Article Text |
id | pubmed-7342577 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Editorial office of Chinese Journal of Hematology |
record_format | MEDLINE/PubMed |
spelling | pubmed-73425772020-07-16 血友病性关节病HEAD-US半定量超声评估量表的临床应用及优化探索 Zhonghua Xue Ye Xue Za Zhi 论著 OBJECTIVE: To assess the feasibility of HEAD-US scale in the clinical application of hemophilic arthropathy (HA) and propose an optimized ultrasound scoring system. METHODS: From July 2015 to August 2017, 1 035 joints ultrasonographic examinations were performed in 91 patients. Melchiorre, HEAD-US (Hemophilic Early Arthropathy Detection with UltraSound) and HEAD-US-C (HEAD-US in China) scale scores were used respectively to analyze the results. The correlations between three ultrasound scales and Hemophilia Joint Health Scores (HJHS) were evaluated. The sensitivity differences of the above Ultrasonic scoring systems in evaluation of HA were compared. RESULTS: All the 91 patients were male, with median age of 16 (4–55) years old, including 86 cases of hemophilia A and 5 cases hemophilia B. The median (P(25), P(75)) of Melchiorre, HEAD-US and HEAD-US-C scores of 1 035 joints were 2(0,6), 1(0,5) and 2(0,6), respectively, and the correlation coefficients compared with HJHS was 0.747, 0.762 and 0.765 respectively, with statistical significance (P<0.001). The positive rates of Melchiorre, HEAD-US-C and HEAD-US scale score were 63.0% (95%CI 59.7%–65.9%), 59.5% (95%CI 56.5%–62.4%) and 56.6% (95%CI 53.6%–59.6%) respectively, and the difference was statistically significant (P<0.001). Even for 336 cases of asymptomatic joints, the positive rates of Melchiorre, HEAD-US-C and HEAD-US scale score were 25.0% (95%CI 20.6%–29.6%), 17.0% (95%CI 12.6%–21.1%) and 11.9% (95%CI 8.4%–15.7%) respectively, and the difference was statistically significant (P<0.001). There were significant changes (P<0.05) in the ultrasonographic score of HA before and after onset of hemorrhage in 107 joints of 40 patients. The difference in variation amplitude of HEAD-US-C scores and HEAD-US scores before and after joint bleeding was statistically significant (P<0.001). CONCLUSION: Compared with Melchiorre, there were similar good correlations between HEAD-US, HEAD-US-C and HJHS. HEAD-US ultrasound scoring system is quick, convenient and simple to use. The optimized HEAD-US-C scale score is more sensitive than HEAD-US, especially for patients with HA who have subclinical state, which make up for insufficiency of sensitivity in HEAD-US scoring system Editorial office of Chinese Journal of Hematology 2018-02 /pmc/articles/PMC7342577/ /pubmed/29562448 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2018.02.011 Text en 2018年版权归中华医学会所有 http://creativecommons.org/licenses/by-nc-sa/3.0/ This work is licensed under a Creative Commons Attribution 3.0 License (CC-BY-NC). The Copyright own by Publisher. Without authorization, shall not reprint, except this publication article, shall not use this publication format design. Unless otherwise stated, all articles published in this journal do not represent the views of the Chinese Medical Association or the editorial board of this journal. |
spellingShingle | 论著 血友病性关节病HEAD-US半定量超声评估量表的临床应用及优化探索 |
title | 血友病性关节病HEAD-US半定量超声评估量表的临床应用及优化探索 |
title_full | 血友病性关节病HEAD-US半定量超声评估量表的临床应用及优化探索 |
title_fullStr | 血友病性关节病HEAD-US半定量超声评估量表的临床应用及优化探索 |
title_full_unstemmed | 血友病性关节病HEAD-US半定量超声评估量表的临床应用及优化探索 |
title_short | 血友病性关节病HEAD-US半定量超声评估量表的临床应用及优化探索 |
title_sort | 血友病性关节病head-us半定量超声评估量表的临床应用及优化探索 |
topic | 论著 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342577/ https://www.ncbi.nlm.nih.gov/pubmed/29562448 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2018.02.011 |
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