CAJ | 학술논문

目的探讨高频超声评价重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗重度银屑病关节炎效果的价值.方法对重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗73例重症银屑病关节炎患者于药物治疗前、治疗2周后、治疗12周后采用Siemens Sequoia 512彩色超声诊断仪观察关节肌腱及韧带附着点、滑膜厚度、关节面及关节腔有无积液、滑膜血流情况.按银屑病皮损面积和严重程度(PASI)评分标准计算总有效率.结果治疗前血流信号丰富70例,关节周围软组织回声减少66例,关节处皮下真皮组织增厚54例;治疗2周后血流信号稀疏68例(97.1％,68/70),关节周围软组织回声减低63例(95.4％,63/66),关节处皮下真皮组织增厚较治疗前好转50例(92.6％,50/54);治疗12周后73例患者关节处皮下真皮组织无明显增厚;关节周围软组织回声减低,彩色多普勒检查无明显血流信号.治疗2周后皮损开始减轻(治愈3例+显效4例+有效40例),总有效率64.4％ (47/73);12周所有患者皮损基本消退(治愈15例+显效34例+有效24例),总有效率100.0％ (73/73).治疗期间没有不良反应发生.结论高频超声可更好更准确地评价重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对银屑病关节炎的疗效,丰富了该病疗效评价手段.
목적 탐토고빈초성평개중조인Ⅱ형종류배사인자수체-항체융합단백치료중도은설병관절염효과적개치.방법 대중조인Ⅱ형종류배사인자수체-항체융합단백치료73례중증은설병관절염환자우약물치료전、치료2주후、치료12주후채용Siemens Sequoia 512채색초성진단의관찰관절기건급인대부착점、활막후도、관절면급관절강유무적액、활막혈류정황.안은설병피손면적화엄중정도(PASI)평분표준계산총유효솔.결과 치료전혈류신호봉부70례,관절주위연조직회성감소66례,관절처피하진피조직증후54례;치료2주후혈류신호희소68례(97.1％,68/70),관절주위연조직회성감저63례(95.4％,63/66),관절처피하진피조직증후교치료전호전50례(92.6％,50/54);치료12주후73례환자관절처피하진피조직무명현증후;관절주위연조직회성감저,채색다보륵검사무명현혈류신호.치료2주후피손개시감경(치유3례+현효4례+유효40례),총유효솔64.4％ (47/73);12주소유환자피손기본소퇴(치유15례+현효34례+유효24례),총유효솔100.0％ (73/73).치료기간몰유불량반응발생.결론 고빈초성가경호경준학지평개중조인Ⅱ형종류배사인자수체-항체융합단백대은설병관절염적료효,봉부료해병료효평개수단.
Objective To study the effect of high frequency ultrasonography (HFUS)on severe psoriatic arthritis(PsA)treated with recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein.Methods Tendons and ligaments attachment points,synovial membrane thickness,facet,cavity effusion of joints were analyzed with high resolution uhrasonography in 73 patients with PsA.They were administered recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein.The severity was evaluated with the psoriasis area and severity index(PASI) Score.Then the results of treatment were classified into four grades with the declination of PASA score between pre-and post-treatment:grade 1 (cure),declination ≥95％ ; grade 2 (excellent),declination between 60％ and 94％ ;grade 3 (effective),PASI Score declination between 20％ and 59％ ; grade 4 (no effect):declination ＜ 20％.Total effective rate was the percentage of the patients of graed 1-3.Results Before treatment,rich blood flow signals were detected with high frequency ultrasound in 70 patients ; synovial membrane thickening was in 54 patients; soft tissue echo decreased in 66 patients.Two weeks after treatment,rich blood flow signals were detected in 68 patients (97.1％,68/70) ; synovial membrane thickening was in 50 patients (92.6％,50/54) ; soft tissue echo decreased in 63 patients(95.4％,63/66) ; 12 weeks after treatment,no synovial membrane thickening,soft tissue echo decrease,rich blood flow signal were detected in all patients.Two weeks after treatment,skin lesions were improved (grade 1,3 cases,grade 2,4 cases,grade 3,40 cases,total effective rate 64.4％ (47/73).Twelve weeks after treatment,skin lesions were improved (grade 1,15 cases,grade 2,34 cases,grade 3,24 cases,total effective rate 100.0％ (73/73).No adverse reaction occurred during treatment.Conclusions High frequency ultrasonography is an effective evaluation method for the treatment of severe PsA treated with recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein.