曲安奈德联合甲氨喋呤关节腔注射治疗类风湿关节炎  

Effect of intra-articular injection of triamcinolone acetonide and methotrexate on rheumatoid arthritis

作　　者：李忆农[1] 张胜利[1] 吴月兰[1] 冯修高[1] 

机构地区：[1]解放军福州总医院风湿科,福州350025

出　　处：《实用药物与临床》2009年第5期332-333,共2页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨联合使用甲氨喋呤(MTX)和曲安奈德(TA)关节腔注射治疗类风湿关节炎(RA)的疗效。方法选择2006年1月-2007年4月我院门诊对称性腕或膝关节炎的RA患者37例。选择一对炎症程度相当的膝或腕关节,随机确定一侧,以曲安奈德针(TA)1mL:40mg溶解MTX针(MTX)5mg混匀后关节腔注射(TM组)。对侧作为对照,以相同剂量曲安奈德针关节腔注射(TA组),整体治疗不变,继续按原来方法服用NSAIDs及DMARDs治疗。分别于注射后第1个月、3个月、6个月末观察注射关节的肿胀数、疼痛数、压痛数及相应指数。结果TM组与TA组关节腔注射后,肿胀关节明显减少,而不同时间点两组间差异均有统计学意义(P<0.01)。随访6个月,两组均未发现明显不良反应。结论曲安奈德针联合MTX针关节腔注射治疗类风湿关节炎,其消炎、止痛、消肿和改善患者关节功能的疗效优于单用曲安奈德针关节腔注射,可显著减少复发机会,延迟复发时间,是类风湿关节炎有效的控制方法之一。Objective To discuss the therapeutic effect of intra-articular injection of methotrexate （MTX） and Triamcinolone acetonide （TA） on rheumatoid arthritis （RA）. Methods 37 patients with active RA and a similar degree of inflammation in two symmetrical joints （ wrist, elbow, or knee） were enrolled. The symmetry was assessed by both clinical examination and synovial fluid analysis. TA 40 nag was injected intra-articularly to the target joints （ a side of joint） intra-articular：TA group; and the combination of TA 40 mg with MTX 5 mg were injected to the contralateral joint intra-articularly：TM group. DMARDs and NSAIDs therapy continued. The swollen joint count （SJC） , pain joint count, tender joint count（TJC） and related indexes were recorded. Results The SJC decreased after intra-articular injection, and there were significant differences between the SJC of 2 groups （P 〈 0. 01 ）at different time points. No seri- ous adverse event was observed in 2 groups. Conclusion MTX-TA is more effective, and the method should be considered the better choice for intra-articulax treatment of RA.

关 键 词：甲氨喋呤(MTX) 曲安奈德 关节腔内注射 类风湿关节炎 

分 类 号：R593.22[医药卫生—内科学] R619.6[医药卫生—临床医学]