^(153)Sm-柠檬酸-羟基磷灰石滑膜切除术治疗类风湿关节炎膝关节积液  

A study of ^(153)Sm-citrate-hydroxyapatite synovectomy in knee synovitis with rheumatoid arthritis

作　　者：范仰钢[1] 李国华[1] 姚国忠[1] 张庆诚[1] 李光明[2] 

机构地区：[1]武警上海总队医院风湿科,201103 [2]武警上海总队医院 核医学科,201103

出　　处：《中华核医学杂志》2006年第2期112-114,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的观察^(153)Sm-柠檬酸-羟基磷灰石(HA)滑膜切除术治疗类风湿关节炎(RA)持续性膝关节积液的疗效和安全性。方法常规抗风湿药物治疗无效的 RA 患者43例,共67个持续性积液的膝关节,行^(153)Sm-柠檬酸-HA 滑膜切除术,观察其疗效和不良反应。结果注射后24 h 8例患者关节外放射性泄漏占注射总量的百分比均<1%。随访至治疗后3、6、12、24和36个月,总有效率分别为65.7%、85.1%、77.6%、64.2%和56.7%。随访至36个月时,治疗有效的关节复发率为33.3%。治疗有效的关节表现为肿痛缓解,积液量减少,滑膜厚度减小,关节功能活动改善。不良反应主要为一过性关节肿痛加重。结论 ^(153)Sm-柠檬酸-HA 滑膜切除术治疗 RA 持续性膝关节积液短期、中期疗效及安全性较好。Objective To investigate the efficacy and safety of ^153Sm-citrate-hydroxyapatite （HA） synovectomy in knee synovitis with rheumatoid arthritis （RA）. Methods In 43 RA patients ineffective to routine anti-rheumatic drugs（DMMARDs） therapy, radiation synovectomy was performed by ^153Sm-citrate- HA in 67 joints and its efficacy and safety were evaluated. Results Radioactivity was evenly distributed as observed by gamma camera after injection. In 8 cases leakage of radioactivity was detected after 24 h, and accounted to 〈 1% of the total activity. After follow-up for 3, 6, 12, 24 and 36 months, the effective rates were 65.7%, 85.1%, 77.6%, 64.2% and 56.7% respectively. The swelling and pain were released, synovia in the articular cavity was reduced, thickness of synovium was reduced and the joint function was improved. The relapse rate was 33.3% after 36 months. The adverse effect was transient with local swelling and pain. Conehmion The treatment of knee synovitis in RA by ^153Sm-citrate-HA synovectomy is effective after short-term and medium-term follow-up and it is a safe procedure.

关 键 词：关节炎 类风湿 关节积水 近距离放射疗法 钐 柠檬酸盐类 羟基磷灰石类 

分 类 号：R817[医药卫生—影像医学与核医学]