Study On The Correlation Between Hepatic And Renal Deficiency Rheumatoid Arthritis And Magnetic Resonance Manifestations Of Knee Joint

Objective: To investigate the correlation between MRI findings of knee joint and clinical and laboratory indexes in patients with rheumatoid arthritis with liver and kidney deficiency,so as to provide theoretical basis for the treatment and prognosis of RA patients with liver and kidney deficiency.Methods: A total of 60 patients with RA with hepatic and renal deficiency admitted to the Department of Rheumatology,Affiliated Hospital of Jiangxi University of Chinese Medicine from November 2019 to October 2020 were selected,according to the laboratory serological indicators(RF,anti CCP antibody,ESR,CRP),the patients were divided into negative group and positive group;according to the joint function classification,they were divided into four stages(I,II,III,IV);according to the course of disease,they were divided into early stage(course of disease ≤ 24 months)and middle late stage(course of disease > 2 months)The synovial thickening,joint cavity effusion,bone erosion,meniscus injury and ligament injury of the knee joint were examined by MRI plain scan method.The clinical data and laboratory indexes such as RF,anti CCP antibody,CRP and ESR of all patients were recorded to study the correlation between MRI and clinical and laboratory indexes of liver kidney deficiency syndrome in rheumatoid arthritis.Results:(1)The MRI findings of 60 cases of hepatorenal deficiency rheumatoid arthritis included synovial thickening in 55 cases(91.67%),joint effusion in 52 cases(86.67%),bone erosion in 37 cases(61.67%),meniscus injury in 34 cases(56.67%),and ligament injury in 26 cases(43.33%),among which synovial thickening was the most common lesion.(2)The difference between RF positive group and RF negative group in synovial thickening and ligament injury was statistically significant(P < 0.05),but there was no significant difference between the two groups in joint cavity effusion,bone erosion and meniscus injury(P ≥ 0.05);the difference between RF positive group and RF negative group in bone erosion,meniscus injury and ligament injury was statistically significant(P >0.05)There was significant difference between the two groups(P < 0.05),but there was no significant difference between the two groups(P > 0.05);there was significant difference between the ESR positive group and the ESR negative group(P < 0.05),and there was significant difference between the two groups(P < 0.05)There was no significant difference between the two groups(P > 0.05);there was significant difference in synovial thickening and ligament injury between the two groups(P < 0.05);there was no significant difference in joint cavity effusion,bone erosion and meniscus injury between the two groups(P > 0.05);(3)There was no significant difference in knee joint MRI performance in joint function classification(P > 0.05);4)The incidence of synovial thickening was significantly different with the course of disease(P < 0.05),but not with the incidence of articular cavity effusion,bone erosion,meniscus injury and ligament injury(P > 0.05);(5)The duration of disease was positively correlated with the level of anti-CCP antibody(r=0.365,P=0.004).Conclusion: MRI is an effective auxiliary means for the diagnosis of RA.1.When RF is positive in RA patients with hepatic and renal deficiency,knee MRI is more prone to synovial thickening and ligament injury;2.When anti CCP antibody was positive in RA patients with liver and kidney deficiency,bone erosion,meniscus injury and ligament injury were more likely to occur on knee MRI;3.Patients with hepatic and renal deficiency RA were more prone to synovial thickening and ligament injury in knee MRI when ESR was positive;4.Patients with liver and kidney deficiency type RA were more prone to synovial thickening and ligament injury in knee MRI when CRP was positive;5.Knee MRI is more sensitive to advanced synovial thickening in patients with hepatic and renal deficiency RA;6.There was a positive correlation between the course of disease and the level of anti-CCP antibody in the patients with hepatic and renal deficiency RA.