Romatoid artritli hastalarda elde oluşan nörovasküler komplikasyonların B mod ve renkli doppler ultrasonografi ile değerlendirilmesi

Yıl 2015, Cilt: 12 Sayı: 3, 356 - 362, 30.12.2015

Ahmet Boyacı Nurefşan Boyacı Alparslan Yetişgin , Ahmet Tutoğlu Dilek Şen Dokumacı

Öz

Amaç: Romatoid artrite (RA) bağlı olarak el bileğinde oluşan kas iskelet sistemi hastalıklarını ultrasonografi
ile tespit etmek ve RA'lı hastalarda arteryel dopplerdeki kan akım patern değişikliklerini saptamak
amaçlanmıştır.
Materyal ve metod: Amerikan Romatizma Birliği (ACR) kriterlerine göre RAtanısı koyulmuş 35 hasta (70
el bileği) ve kontrol grubu olarak 20 sağlıklı gönüllü (40 el bileği) çalışmaya alındı. Median sinir kesit alanı
(MSA), anteroposterior (AP) ve transvers çaplar, karpal tünel girişi [proksimal (p)] ve bilek kıvrımı [distal
(d)] düzeylerinde ölçüldü. Karpal tünel girişi düzeyinde fleksör retinakulum kalınlığı değerlendirildi. Renkli
Doppler ultrason incelemesinde her iki el nötral pozisyonda iken radial ve ulnar arterler yüksek rezolüsyonlu
12 MHz transduser (Logic 7) ile değerlendirildi.
Bulgular: Gruplar arası karşılaştırmada RA grubunda, kontrol grubuna göre AP-p ve AP-d çaplar anlamlı
olarak daha küçük bulundu (p<0,05). RAgrubunda radial arter akım hızı ve pik sistolik hızda anlamlı azalma
bulundu (p<0,05). Diğer B mod ve doppler ultrasonografi ölçümlerinde gruplar arası anlamlı fark yoktu
(p>0,05).
Sonuç: KTS klinik bulgu ve semptomu olmayan orta hastalık aktivitesine sahip RA'lı hastalarda sağlıklı
kontrollere göre MSA sonuçları benzerdir. Kronik inflamasyona bağlı olarak median sinirin vazomotor
fonksiyonlarındaki bozukluk radial kan akımındaki azalmayı açıklayabilir.

Anahtar Kelimeler

Romatoid Artrit, Median Sinir, Ultrasonografi

Assessment Of Mean Platelet Volume In Patients With Severe ObEvaluation of neurovascular complications of hand by B-mode and color Doppler ultrasonography in patients with rheumatoid arthritis structive Sleep Apnea

Öz

Objective: The aim of the study is to detect the musculoskeletal diseases of the wrist depending on
rheumatoid arthritis (RA) by ultrasound and to determine changes in arterial Doppler blood flow patterns in
patients with RA.
Materials and Methods: 35 patients (70 wrists) with a diagnosis of RA according to the American College
of Rheumatology criteria and a control group of 20 healthy volunteers (40 wrists) were enrolled in the study.
The median nerve cross-sectional area (MSA), anteroposterior (AP), and transverse diameters at the levels of
carpal tunnel entrance [proximal (p)] and wrist bend [distal (d)] were measured. The flexor retinaculum thickness was evaluated at the level of carpal tunnel entrance. In the color Doppler ultrasound examination,
radial and ulnar arteries were evaluated with high resolution 12 MHz transducer (Logic 7) while both hands
were in a neutral position.
Results: In comparison between the groups, AP-p and AP-d diameters were significantly smaller in the RA
group than in the control group (p<0.05). The radial artery flow velocity and peak systolic velocity were
significantly decreased in the RAgroup (p<0.05). There was no significant difference between the groups in
other B-mode and Doppler ultrasonography measurements (p>0.05).
Conclusion: RA patients with moderate disease activity and without clinical signs and symptoms of CTS
have similar MSA results compared to healthy controls. The vasomotor function disorder depending on the
chronic inflammation in median nerve may explain the reduction of radial blood flow.

Anahtar Kelimeler

Rheumatoid Arthritis, Median Nerve, Ultrasonography

Kaynakça

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