病灶内注射甲强龙治疗儿童骨朗格罕细胞组织细胞增生症的疗效观察  

Intralesional methylprednisolone injection for bone Langerhans cell histiocytosis in children

作　　者：陈秉耀 韦兴 宋光泽 张增亮 张迎龙 冯丽丽[1] CHEN Bing-yao;WEI Xing;SONG Guang-ze;ZHANG Zeng-liang;ZHANG Ying-long;FENG Li-li(Department of Orthopedics,Aerospace Center Hospital,Beijing,100049,China)

机构地区：[1]航天中心医院骨科,北京100049 [2]解放军总医院第四医学中心骨科,北京100048

出　　处：《中国骨与关节杂志》2020年第10期779-782,共4页Chinese Journal of Bone and Joint

摘　　要：目的评价病灶内注射甲强龙治疗骨郎格罕细胞组织细胞增生症 (langerhans cell histiocytosis,LCH) 患儿的临床疗效。方法对 2012 年 6 月至 2018 年 3 月我院收治的骨 LCH 患儿的临床资料进行分析,本组共 8 例,年龄 1~6 岁,平均 (3.1±1.1) 岁。其中男 3 例,女 5 例,四肢骨 6 例,骨盆 2 例。7 例先行穿刺活检明确诊断,之后病灶内注射甲强龙 80~120 mg,1 例穿刺活检同时注射药物,3 例治疗后 1 个月重复注射 1 次。定期复查,了解症状改善及影像学变化。随访时间 12~50 个月,平均 23.1 个月。结果本组患儿甲强龙注射后临床症状及影像学表现均迅速改善,治疗后 2 年左右骨修复基本完成,其中 1 例右股骨下段病变治疗后 2 个月左侧股骨近端新发病灶,经治疗后两处病灶均愈合。结论骨 LCH 病灶内注射激素治疗骨 LCH 安全有效,短期内即可出现症状改善及骨质修复。Objective To evaluate clinical and imaging outcomes of bone Langerhans cell histiocytosis(LCH) after methylprednisolone injection.Methods Eight LCH patients,admitted from June 2012 to March 2018,were analyzed,including 3 males and 5 females with a mean age of (3.1±1.1) years (range:1-6 years).Lesions located in the limbs (6 patients) and pelvis (2 patients).Seven patients were injected methylprednisolone after biopsy,while 3 patients among them repeated the treatment 1 month later.One patient was injected methylprednisolone during biopsy.The mean follow-up was 23.1 months (range:12-50 months).Results Clinical symptoms and imaging manifestations improved rapidly after methylprednisolone injection,and bone repair was basically achieved about2 years after treatment.New left proximal femur lesion was observed after the right lower femur treatment of 2 months.However,both lesions healed after treatment.Conclusions Intralesional methylprednisolone injection is safe for bone LCH in children with effective clinical and imaging outcomes.

关 键 词：儿童 组织细胞增多症 郎格尔汉斯细胞 骨 甲强龙 

分 类 号：R681[医药卫生—骨科学]