High-frequency ultrasound combined with modified Rodnan skin score in systemic sclerosis / 中华风湿病学杂志

ABSTRACT

Objective The purpose of this study was to evaluate the degree of skin thickening of patients with systemic sclerosis (SSc) by high-frequecy ultrasound,as well as the value of ultrasound.Methods Thirty-one patients with SSc and 31 age-matched and sex-matched healthy control subjects were enrolled.Skin thickness,modified Rodnan skin score (mRss),disease activity index (DA1) and other clinical parameters within and between groups were compared using SPSS 21 software.Student's t test,x2 test or nonparametric testing was performed to compare between groups.The Pearson or Spearman methods were used to test correlation.Sensitivity and specificity of skin thickness detection by high-frequecy ultrasound were evaluated by using receiver operating characteristic (ROC) curve analysis.Results Total thickness of skin (TST) of patientswith SSc were positively correlated to the total mRss (r=0.416,P=0.020) and DAI (r=0.436,P=0.014).The skin thickness of patients with mRss 0,1,2 was higher than CNT [1.45(0.60),1.70(0.30) mm,1.60 (0.30) mm vs 1.30 (0.35) mm,Z=-3.242,-6.577,-5.090,P＜0.01].The cut-off value of TST used as the evaluation of skin change was 7.4 mm by ROC curve analysis,and the sensitivity and specificity of them was 77.40％ and 87.10％ respectively,and patients with thickened skin were more likely to suffer interstitial lung disease (ILD) (16 vs 1,x2=26.004,P=0.014),higher mRss [10(6) vs 4(5),Z=-2.499,P=0.031],DAI [(5.2±2.4) vs (2.3±1.7),t=-3.104,P＜0.01)] and CRP [(8.60 (10.48) mg/L vs 3.52 (4.93) mg/L,Z=-2.276,P=0.038].Conclusion US combined with mRss are helpful to evaluate the changes of skin and disease activity of patients in SSc.US can identify the early and subclinical skin involvement that may precede mRss,providing a more reliable tool for diagnosis,treat efficacy and prediction of organ damage.