中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2011年
29期
2034-2037
,共4页
陈国强%张红卫%黎志锋%余旸弢%郭冬梅
陳國彊%張紅衛%黎誌鋒%餘旸弢%郭鼕梅
진국강%장홍위%려지봉%여양도%곽동매
关节镜%改善病情抗风湿药物%关节炎%类风湿
關節鏡%改善病情抗風濕藥物%關節炎%類風濕
관절경%개선병정항풍습약물%관절염%류풍습
Arthroscopy%Drugs,disease-modifying antirheumatic%Rheumatoid arthritis
目的 评价关节镜下滑膜切除术联合改善病情抗风湿药物(DMARD)治疗类风湿关节炎(RA)的临床疗效.方法 对97例RA患者进行关节镜下膝关节滑膜切除术,术后即联合使用DMARD药物治疗;对照组仅使用DMARD药物治疗.于关节镜手术后及药物治疗的1、6、12及24个月作为随访点,比较患者治疗前后的DAS28评分及其临床缓解率(DAS28＜2.6)、关节压痛数、关节肿胀数、晨僵时间、疼痛目视模拟测量表(VAS)评分、疾病总体状况的医生VAS评分、疾病总体状况的患者VAS评分、血红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)等指标.结果 治疗后第1、第6个月时,关节镜滑膜切除术联合DMARD药物治疗组DAS28评分分别为4.8±1.1、4.2±1.0,对照组分别为5.4±0.9、4.9±1.5,差异均有统计学意义(均P＜0.05).治疗组第1、第6个月时关节压痛数、关节肿胀数、晨僵时间、疼痛VAS评分、疾病总体状况的医生VAS评分、患者VAS评分与对照组相比有显著改善.治疗后1个月起达到临床缓解(DAS28＜2.6)的比率与对照组相比有显著差异且一直维持到24个月,治疗2年后两组间DAS28评分差异仍有统计学意义.结论 关节镜下滑膜切除术联合DMARD较单用DMARD治疗RA可更早控制疾病活动度,改善病情,同时可以维持长期疗效.
目的 評價關節鏡下滑膜切除術聯閤改善病情抗風濕藥物(DMARD)治療類風濕關節炎(RA)的臨床療效.方法 對97例RA患者進行關節鏡下膝關節滑膜切除術,術後即聯閤使用DMARD藥物治療;對照組僅使用DMARD藥物治療.于關節鏡手術後及藥物治療的1、6、12及24箇月作為隨訪點,比較患者治療前後的DAS28評分及其臨床緩解率(DAS28＜2.6)、關節壓痛數、關節腫脹數、晨僵時間、疼痛目視模擬測量錶(VAS)評分、疾病總體狀況的醫生VAS評分、疾病總體狀況的患者VAS評分、血紅細胞沉降率(ESR)、C反應蛋白(CRP)、類風濕因子(RF)等指標.結果 治療後第1、第6箇月時,關節鏡滑膜切除術聯閤DMARD藥物治療組DAS28評分分彆為4.8±1.1、4.2±1.0,對照組分彆為5.4±0.9、4.9±1.5,差異均有統計學意義(均P＜0.05).治療組第1、第6箇月時關節壓痛數、關節腫脹數、晨僵時間、疼痛VAS評分、疾病總體狀況的醫生VAS評分、患者VAS評分與對照組相比有顯著改善.治療後1箇月起達到臨床緩解(DAS28＜2.6)的比率與對照組相比有顯著差異且一直維持到24箇月,治療2年後兩組間DAS28評分差異仍有統計學意義.結論 關節鏡下滑膜切除術聯閤DMARD較單用DMARD治療RA可更早控製疾病活動度,改善病情,同時可以維持長期療效.
목적 평개관절경하활막절제술연합개선병정항풍습약물(DMARD)치료류풍습관절염(RA)적림상료효.방법 대97례RA환자진행관절경하슬관절활막절제술,술후즉연합사용DMARD약물치료;대조조부사용DMARD약물치료.우관절경수술후급약물치료적1、6、12급24개월작위수방점,비교환자치료전후적DAS28평분급기림상완해솔(DAS28＜2.6)、관절압통수、관절종창수、신강시간、동통목시모의측량표(VAS)평분、질병총체상황적의생VAS평분、질병총체상황적환자VAS평분、혈홍세포침강솔(ESR)、C반응단백(CRP)、류풍습인자(RF)등지표.결과 치료후제1、제6개월시,관절경활막절제술연합DMARD약물치료조DAS28평분분별위4.8±1.1、4.2±1.0,대조조분별위5.4±0.9、4.9±1.5,차이균유통계학의의(균P＜0.05).치료조제1、제6개월시관절압통수、관절종창수、신강시간、동통VAS평분、질병총체상황적의생VAS평분、환자VAS평분여대조조상비유현저개선.치료후1개월기체도림상완해(DAS28＜2.6)적비솔여대조조상비유현저차이차일직유지도24개월,치료2년후량조간DAS28평분차이잉유통계학의의.결론 관절경하활막절제술연합DMARD교단용DMARD치료RA가경조공제질병활동도,개선병정,동시가이유지장기료효.
Objective To evaluate the clinical efficacy of knee arthroscopic synovectomy plus disease-modifying antirheumatic drug (DMARD) for the treatment of rheumatoid arthritis (RA) patients.Methods A total of 97 RA patients were treated with knee arthroscopic synovectomy plus DMARD after arthroscopy. The control group received only DMARD. The patients were assessed at pre-treatment and 1,6, 12, 24 month post-treatment. Tender joint count, swollen joint count, morning stiffness, resting pain,patient global assessment, physician global assessment, erythrocyte sedimentation rate ( ESR), C-reactive protein (CRP), rheumatoid factor (RF) and disease activity score (DAS) 28 were observed. Results Tender joint count, swollen joint count, morning stiffness, resting pain, patient global assessment, physician global assessment and DAS 28 score improved significantly at 1, 6 month post-treatment in the combined treatment group versus the control group. At 2 years post-treatment, there was still significant difference in DAS28 between two groups. Conclusion The combined treatment of knee arthroscopic synovectomy and disease modifying antirheumatic drugs can control the disease activity of RA during an early period. And a long-term efficacy may be maintained.
