【摘要】 目的观察153钐-柠檬酸-羟基磷灰石(153Sm-Citrate-HA)放射性滑膜切除术治疗类风湿关节炎(RA),分析药物在关节腔内的弥散情况与疗效关系。方法对36例RA患者56个有明显滑膜增生的膝关节行关节腔内注射153Sm-Citrate-HA185MBq/0.5～1ml,比较治疗前后关节症状(疼痛、肿胀、积液、功能活动度、上下楼及蹲站有无困难)变化情况,按优效、良效、微效、无效4级标准评判疗效,γ显像表现药物在关节腔内弥散情况分为良好、较差两种评判标准分析疗效,并对不同分期(以X线分期为标准)患者的疗效进行分析。结果治疗后6个月,药物在关节腔内弥散良好的患者优、良效率合计为81.1%,弥散较差的患者无优效,良效率为52.6%;按X线分期Ⅰ,Ⅱ期患者的优、良效率合计分别为100%,87.5%,Ⅲ期患者疗效稍差。结论采用153Sm-Citrate-HA行滑膜切除术治疗类风湿关节炎滑膜增生性变,药物在关节腔内弥散良好的X线分期Ⅰ,Ⅱ期患者疗效显著。更多还原

【Abstract】 Objective To investigate the effects of radiation synovectomy with 153Sm-Citrate-HA in knees of patients with rheumatoid arthritis(RA).Methods 56 knees with thickened synovium from 36 RA patients were injected with 185MBq/0.5~1ml of 153Sm-Citrate-HA.Clinical symptoms including articular pain,edema,fluid,and activity were compared before and after injection.Efficacy was evaluated as four grades.Relationship between different X-ray grade in knees and their treatment outcome was analyzed too.Results Efficacy was observed one week after intra-articular injection and increased within 6 months.Total efficiency is 98.1%,with 100% and 91.3% in patients of I and II X-ray grades.Conclusion Radiation synovectomy with 153Sm-Citrate-HA injected into knees of patients with RA is a simple,safe and effective therapy,especially in those with I to II X-ray grade.更多还原