局部应用依那西普治疗强直性脊柱炎髋关节受累的临床疗效分析  

Clinical Efficacy of Etanercept hip joint Injection in the Treatment of Patients with Ankylosing Spondylitis

作　　者：李伟[1] 高杰[1] 赵育松[1] 孙铀[1] 王晓东[1] 

机构地区：[1]哈尔滨医科大学附属第二医院,黑龙江哈尔滨150086

出　　处：《现代生物医学进展》2013年第25期4917-4920,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81202339)

摘　　要：目的:评价局部应用依那西普治疗强直性脊柱炎髋关节受累的短期疗效。方法:选择我科2001-2011年收治的强直性脊柱炎髋关节受累的患者50例,在高频超声引导下于髋关节局部注射依那西普50 mg,每周1次,连用4次。分别在注射前、注射后2、4、8周观察患者的BASDAI、BASFI、脊柱痛VAS、患者总体评价(PGA)VAS、夜间痛VAS、血沉、CRP和Harris功能评分,同时记录患者出现的不良反应。结果:依那西普治疗2周时,30例达ASAS20的缓解(60%),13例(26%)达到ASAS50的缓解,8例(16%)达到ASAS70的缓解;治疗8周时,ASAS20/50/70的缓解率分别为38例(64%)、21例(42%)、15例(30%),其中Harris评分达70以上者占总人数的90%,80分60%,90分30%,1例患者缓解不明显,4例患者处于70分以下,但疾病活动度情况改善。结论:依那西普可有效改善强直性脊柱炎髋关节受累患者的关节症状,降低疾病活动强度,且无明显药物不良反应。Objective： To evaluate the short-term efficacy of etanercept hip joint injection in the treatment of patients with anky- losing spondylitis. Methods： 50 cases with ankylosing spondylitis admitted in our hospital from 2001 to 2011 were injected into hip joint with etanercept 50 mg once a week for a treatment course of 4 weeks under the high-frequency ultrasound. The Bath Ankylosing Spondylitis Functional Index （BASFI）, Bath Ankylosing Spondylitis Disease Activity Index （BASDAD, spinal pain VAS, （FGA）VAS, nocturnal spinal pain VAS, ESR, C-reactive protein （CRP）, Harris and possible adverse reaction were observed at week 0, 2, 4, 8 respec- tively. Results： Compared with the baseline, the observation items were all significantly improved after 2, 4 and 8 weeks＇ treatment. At 2nd week, 60%（n=30）, 26%（n=13） and 16%（n=8） of the patients achieved ASAS20, ASAS50 and ASAS70, respectively. At 8th week, the percentage of patients achieving the ASAS20/50/70 were 64%（n=38）, 42%（n=21）, 30%（n=15）respectively. The percentage of re spon- ders, above 70 of Harris was 90%, above 80 was 60%, and above 90 was 30%. 1 patient had no improvement. And there were 4 patients below 70, but had recuding clinical signs. Conclusion： Etanercept was clinically effective and well tolerated in the treatment of AS pa- tients, which could provide fast action, reduce clinical signs and improve range of motion as well as quality of life.

关 键 词：强直性脊柱炎 肿瘤坏死因子 依那西普 髋关节 

分 类 号：R684.3[医药卫生—骨科学]