锝[99~Tc]亚甲基二膦酸盐联合关节腔内注射玻璃酸钠和倍他米松治疗膝骨性关节炎合并骨质疏松症的临床观察  

Clinical Observation of 99Tc-MDP Combined with Intra-articular Injection of Sodium Hyaluronate and Betamethasone in the Treatment of Knee Osteoarthritis Complicating with Osteoporosis

作　　者：刘璘琛[1] 苗雷[1] 刘葵 

机构地区：[1]东南大学附属中大医院风湿科8病区,南京210009 [2]湖北省通城人民医院,湖北通城437400

出　　处：《中国药房》2015年第5期675-678,共4页China Pharmacy

摘　　要：目的:观察锝[99Tc]亚甲基二膦酸盐注射液(99Tc-MDP)联合关节腔内注射玻璃酸钠和倍他米松在膝骨性关节炎合并骨质疏松症患者治疗中的疗效和安全性。方法:膝骨性关节炎合并骨质疏松症的患者128例,随机分为治疗组与对照组,每组64例。对照组给予关节腔内注射玻璃酸钠和复方倍他米松注射液,治疗组给予99Tc-MDP静脉滴注及关节腔内注射玻璃酸钠和复方倍他米松注射液。40 d为1疗程,共4个疗程。所有患者均口服碳酸钙D3片,持续半年。观察记录视觉模拟评分(VAS)值、西安大略麦马斯特大学骨性关节炎指数可视化量表(Womac)评分及膝关节炎患者疼痛指数、膝关节周长、关节积液量,并进行疗效评价;记录腰椎和髋部骨密度(BMD)值,尿吡啶酚(PYD)、血清骨钙素(BGP)的变化和不良反应发生情况。结果:治疗4个疗程后,治疗组各骨关节炎指标改善程度均高于对照组(P<0.05),停药2周后,治疗组无反弹,而对照组反弹明显,两组差异有统计学意义(P<0.05);治疗组有效率为92.19%,明显高于对照组的76.56%(P<0.05);治疗组膝关节周长和关节积液量的减少较对照组明显(P<0.05);治疗组对骨质疏松改善程度均较对照组明显(P<0.05);治疗组不良反应发生率(3.12%)明显低于对照组(10.94%)(P<0.05)。结论:99Tc-MDP联合关节腔内注射玻璃酸钠和倍他米松在膝骨性关节炎合并骨质疏松症患者的治疗中疗效确切而持久,且不良反应少。OBJECTIVE： To observe therapeutic efficacy and safety of 99Tc-MDP injection combined with intra-articular injection of sodium hyaluronate and betamethasone in the treatment of knee osteoarthritis complicating with osteoporosis. METHODS： 128 patients with knee osteoarthritis osteoporosis were randomly divided into treatment group and control group with 64 cases in each group. The control group was given intra-articular injection of sodium hyaluronate and compound betamethasone; the treatment group was given intravenous dripping of 99Tc-MDP combined with intra-articular injection of sodium hyaluronate and compound betamethasone. A treatment course lasted for 40 d, a total of 4 courses were given. All patients were Calcium carbonate D3 tablets orally for six months. Efficacy evaluation was conducted by observing and recording visual analog scale （VAS） values, Westem Ontario and McMaster University osteoarthritis index visualization scale （Womac） and Lequesne index, knee circumference and joint effusion; bone mineral density （BMD） values of lumbar spine and hip , pyridinoline （PYD） and bone gla protein （BGP） changes and adverse reactions were recorded. RESULTS： After 4 treatment courses, the improvement of osteoarthritis index in treatment group were higher than in control group（P〈0.05）. 2 weeks after drug withdrawal, there＇s no rebound in treatment group, rebound significantly in the control group. There were statistically significant difference（P〈0.05） ; effective rate of 92.19% in treatment group was significantly higher than 76.56% in control group（P〈0.05） ;The decrease of knee circumference and joint effusion in treatment group were more significant than in control group （P〈0.05）; the improvement of osteoporosis in treatment group was more significant than in control group （P〈0.05）;The incidence of ADR （3.12 % ） in treatment group was significantly lower than （ 10.94 % ） in control group （P〈 0.05）.CONCLUSIONS： ^99Tc-MDP combined with intra

关 键 词：锝[99Tc]亚甲基二膦酸盐注射液 关节腔内注射 玻璃酸钠 骨关节炎 骨质疏松症 

分 类 号：R681[医药卫生—骨科学] R969.4[医药卫生—外科学]