关节腔内注射透明质酸钠治疗大骨节病的疗效观察  

Curative effects of intra-articular injections of sodium hyaluronate to treat Kaschin-Beck disease

作　　者：许鹏[1] 郭雄[1] 靳卫章[2] 姚建锋[2] 王锦辉 张富强 张银刚[1] 

机构地区：[1]西安交通大学环境与疾病相关基因教育部重点实验室地方病研究所,710061 [2]西安市红十字会医院 [3]陕西省永寿县地方病防治研究所 [4]陕西省永寿县医院

出　　处：《中国地方病学杂志》2004年第6期588-590,共3页Chinese Jouranl of Endemiology

基　　金：陕西省卫生厅地方病防治处资助项目(2003)西安市科技攻关计划项目(GG04123)

摘　　要：目的 观察透明质酸钠(SH)关节腔内注射治疗中晚期大骨节病的疗效。方法90例膝关节症状明显的中晚期大骨节病患者随机分为两组,Ⅰ组口服维生素C治疗,Ⅱ组SH膝关节内注射治疗,对治疗前后膝关节整体情况参照Lequesne的骨关节炎严重性和活动性指数评估方法评分比较。结果治疗第1、2周和治疗后3、6个月的膝关节评分结果显示,Ⅰ组患者关节积分值较治疗前稍有降低,但差异无统计学意义(F=7.65,P>0.05);Ⅱ组患者关节积分值较治疗前明显降低(F=18_21,P<0.05),且随时间的延长积分值不断降低;同一观察时间内比较Ⅱ组的关节积分值明显低于Ⅰ组(P<0.05);治疗后6个月随访,Ⅰ组总有效率为22.50％,Ⅱ组总有效率为93.62％,Ⅱ组治疗疗效明显好于Ⅰ组。结论 SH关节腔内注射是改善中晚期大骨节病负重关节功能和缓解其症状的一种安全有效的治疗方法。Objective To observe the therapeutic effects of intra-articular injections of sodium hyaluronate (IA SH) to treat patients with Kaschin-Beck disease (KBD) in the advanced stage. Methods 90 KBD patients were randomly divided into two groups. The patients in group I were treated by vitamin C orally, and in group Ⅱ by IA SH. Complexion of knee joint in pre- and pro-treatment was graded according to the criterion of Lequesne's assessment method for the severity and activity of osteoarthritis. Results The knee joint values of patients in the pro-treatment of 1 week, the 2 week, the 3rd month and 6th month were slightly lower than those of pre-treatment,but not significantly different (F= 7.65,P> 0.05) in group Ⅰ , and the joint values of pro-treatment which gradually fell with the time gone were significantly lower than those of pre-treatment ( F = 18.21, P < 0.05 ) in group Ⅱ . At the same observative time, the joint values in group Ⅱ were notably lower than that in group Ⅰ (P < 0.05). The curative effects in group Ⅱ were much better than those in group I from the beginning of the treatment. After treated for 6 month, the total recovery rates in group Ⅰ and group Ⅱ were 22.50% and 93.62%, respectively. Conclusions IA SH has marked effects to improve the function in knee of patients and relieve their symptoms of KBD.

关 键 词：关节腔内注射 透明质酸钠 药物治疗 大骨节病 关节功能 

分 类 号：R684.1[医药卫生—骨科学] R982[医药卫生—外科学]