局部注射治疗幼年脊柱关节病髋关节病变临床研究  

Clinical Study of Local Injection in the Treatment of Patients with Juvenile Spondyloarthropathies Hip Pathology

作　　者：梅永君[1] 石士奎[2] 石彦[3] 宁艳[3] 谢长好[1] 王涛[1] 范晓云[1] 陈琳洁[1] 李志军[1] 

机构地区：[1]安徽省蚌埠医学院第一附属医院风湿免疫科,233004 [2]安徽省蚌埠医学院第一附属医院CT室,233004 [3]安徽省蚌埠医学院第一附属医院功能科,233004

出　　处：《中华全科医学》2012年第5期678-679,共2页Chinese Journal of General Practice

基　　金：安徽省卫生厅重点学科科研基金(2008A007)

摘　　要：目的观察肿瘤坏死因子拮抗剂(依那西普)联合甲氨蝶呤(MTX)局部注射治疗幼年脊柱关节病(JSpA)相关髋关节病变的疗效和影像学变化。方法 8例JSpA和对照组13例强直性脊柱炎(AS)同时伴有单侧或双侧髋关节病变者,采用随机对照性临床研究,均在高频超声引导下髋关节局部注射依那西普+MTX,每月1次,共注射6次。结果JSpA组11个髋关节和对照组AS患者17个髋关节Harris评分治疗前后比较差异有统计学意义(P<0.01),两组间比较差异无统计学意义(P>0.05),高频超声下JSpA治疗后关节软骨厚度和髋关节间隙增加,两组间差异有统计学意义(P<0.01)。结论依那西普联合MTX局部注射治疗JSpA和AS髋关节病变疗效明显,对JSpA疗效更显著。Objective To observe the clinical and radiographic changes of tumor necrosis factor antagonists（etanercept） combined with methotrexate（MTX）＇s local injection in the treatment of juvenile spondyloarthropathy（JSpA） associated with hip joint disease.Methods 8 cases of JSpA and 13 cases of the control group AS accompanied by unilateral or bilateral hip joint disease were studied by randomly contrasted clinical research.Etanercept ＋ MTX were injected into hip locally under the high frequency ultrasound,once a month,6 injections totally.Results Comparison to Harris score before and after treatment for JSpA group of 11 hip and the contrasted group of patients with AS 17 hip,there was significant difference（P0.01） The difference between two groups had no statistical meaning（P0.05）,Articular cartilage＇s thickness and hip joint＇s space increased after high frequency ultrasound JAS treatment.There were obvious differences between the two groups（P0.01）.Conclusion Curative effect of etanercept combined with MTX JSpA and AS local injection in the treatment of hip joint disease was obvious.Especially the JSpA＇s curative effect was more significant.

关 键 词：脊柱关节病 拮抗剂 肿瘤坏死因子 髋关节 甲氨蝶呤 

分 类 号：R593.23[医药卫生—内科学]