CAJ | 학술논문

目的探讨重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(rhTNFR:Fc)对炎性关节炎患者关节置换术后恢复的影响.方法回顾分析67例应用rhTNFR:Fc或传统改变病情抗风湿药(DMARDs)治疗的炎性关节炎患者行关节置换术后伤口感染发生例数、伤口愈合时间、炎症期时间(体温≥37.5 ℃)及抗生素应用时间.根据所应用药物分为rhTNFR:Fc组和传统DMARDs组.其中,rhTNFR:Fc组单用rhTNFR:Fc或rhTNFR:Fc联合传统DMARDs;传统DMARDs组单用或联合应用2种或2种以上传统DMARDs.统计学处理根据数据类型选择t检验或非参数检验.结果 67例患者中,rhTNFR:Fc组18例,传统DMARDs组49例.rhTNFR:Fc组1例出现伤口感染,传统DMARDs组0例,差异无统计学意义(P＞0.05).rhTNFR:Fc组炎症期时间为(4±3) d,传统DMARDs组为(3±3)d,差异无统计学意义(P＞0.05).rhTNFR:Fc组伤口愈合时间为(14.0±3.1)d,传统DMARDs组为(14.7±2.9)d,差异无统计学意义(P＞0.05).rhTNFR:Fc组术后抗生素应用时间为(14.8±9.3)d,传统DMARDs组为(10.3±2.7)d,差异有统计学意义(P＜0.05).结论炎性关节炎患者围手术期应用rhTNFR:Fc不增加关节置换术后伤口感染发生率,不延长伤口愈合时间及炎症期时间.
목적 탐토중조인Ⅱ형종류배사인자수체-항체융합단백(rhTNFR:Fc)대염성관절염환자관절치환술후회복적영향.방법 회고분석67례응용rhTNFR:Fc혹전통개변병정항풍습약(DMARDs)치료적염성관절염환자행관절치환술후상구감염발생례수、상구유합시간、염증기시간(체온≥37.5 ℃)급항생소응용시간.근거소응용약물분위rhTNFR:Fc조화전통DMARDs조.기중,rhTNFR:Fc조단용rhTNFR:Fc혹rhTNFR:Fc연합전통DMARDs;전통DMARDs조단용혹연합응용2충혹2충이상전통DMARDs.통계학처리근거수거류형선택t검험혹비삼수검험.결과 67례환자중,rhTNFR:Fc조18례,전통DMARDs조49례.rhTNFR:Fc조1례출현상구감염,전통DMARDs조0례,차이무통계학의의(P＞0.05).rhTNFR:Fc조염증기시간위(4±3) d,전통DMARDs조위(3±3)d,차이무통계학의의(P＞0.05).rhTNFR:Fc조상구유합시간위(14.0±3.1)d,전통DMARDs조위(14.7±2.9)d,차이무통계학의의(P＞0.05).rhTNFR:Fc조술후항생소응용시간위(14.8±9.3)d,전통DMARDs조위(10.3±2.7)d,차이유통계학의의(P＜0.05).결론 염성관절염환자위수술기응용rhTNFR:Fc불증가관절치환술후상구감염발생솔,불연장상구유합시간급염증기시간.
Objective To investigate the affect of rhTNFR:Fc on the postoperative recovery of patients with inflammatory arthritis after arthroplasty. Methods Patients with inflammatory arthritis undergoing arthroplasty were included and divided into rhTNFR:Fc group (rhTNFR:Fc only or combined with conven-tional DMARDs) and conventional DMARDs group (monotherapy with or combination of conventional DMARDs). We retrospectively analyzed the incidence of postoperative infection, wound healing time, the febrile period (body temperature ≥37.5 ℃) and the duration of antibiotics treatment after arthroplasty. x2 test and t test were used for statistical analysis. Results Sixty-seven patients were included, 18 in the rhTNFR: Fc group and 49 in the conventional DMARDs group. One postoperative infection occurred in rhTNFR :Fc group but none in the DMARDs group. There was no significant difference by Fisher's exact test (P＞0.05). The febrile duration was (4±3) days in the rhTNFR :Fc group and (3±3) days in the conventional DMARDs group, the difference was not statistically significant (P＞0.05). The wound healing time was (14.0±3.1) days in the rhTNFR :Fc group and (14.7±2.9) days in the conventional DMARDs group, which was not statistically different(P＞0.05). The duration of antibiotics treatment after operation was (14.8±9.3) days in the rhTNFR: Fc group and (10.3±2.7) days in the conventional DMARDs group, the difference was statistically significant (P＜0.05). Conclusion Using rhTNFR:Fc during perioperative period in patients with inflammatory arthritis does not increase the risk of infectious complications or extending wound healing time and the febrile duration.