Comparison and correlation study of synovial ultrasound indices and serum VEGF in rheumatoid wrist arthritis before and after treatment.

Abstract

Rheumatoid wrist arthritis is a chronic autoimmune disease, resulting in joint deformity and functional impairment. We aimed to compare the wrist synovial ultrasound indices and serum vascular endothelial growth factor (VEGF) level in patients with RA before and after treatment, and to explore the correlation between the two. Forty patients with RA in wrist underwent ultrasound examination to determine wrist synovial thickness, synovial blood flow grade, and synovial artery resistive index (RI) before and after treatment. The serum level of VEGF was detected by enzyme-linked immunosorbent assay. Correlation between synovial ultrasound indices and serum VEGF level was assessed. Pre-treatment synovial thickness, synovial artery RI, and serum VEGF level were 8.60 ± 2.82mm, 0.62 ± 0.07, and 419.49 ± 19.27pg/mL, respectively. The corresponding post-treatment levels were 4.05 ± 1.89mm, 0.83 ± 0.10, and 199.30 ± 16.18pg/mL. Pre-treatment distribution of synovial blood flow grades was as follows: grade 0, nil; grade I, 1 case; grade II, 17 cases; grade III, 22 cases. The post-treatment distribution was as follows: grade 0, 6 cases; grade I, 23 cases; grade II, 11 cases; and grade III, nil. There were significant differences between pre- and post-treatment wrist synovial thickness, artery RI, and blood flow grading. Wrist synovial thickness and synovial blood flow grade showed a strong positive correlation with serum VEGF level (P < 0.01). There was strong negative correlation between wrist synovial artery RI and serum VEGF level (P < 0.01). The strong correlation between wrist synovial ultrasound indicators and serum VEGF may be clinically useful for diagnosis and therapy.