摘要
目的对肿瘤坏死因子拮抗剂(依那西普)治疗难治性幼年脊柱关节病(JSpA)相关髋关节病变的临床疗效与安全性进行评价。方法选取对伴有髋关节受累且非甾体抗炎药(NSAIDs)和传统抗风湿慢作用药(DMARDs)疗效不佳的JSpA,给予依那西普皮下注射,疗程12周,评价指标为0、4、8、12周髋关节评分,外周关节炎数、肌腱端炎数、血小板计数(BPC)及实验室炎症反应指标红细胞沉降率(ESR)和C反应蛋白浓度(CRP)等,并随访至36周,观察依那西普减量维持和停用依那西普后患者病情状况,随时记录观察期间不良事件。结果 23例患者均完成了12周的观察。4周后,髋关节活动评分降低,关节炎数和肌腱端炎数均减少,与各自基线水平比较差异有统计学意义(P<0.05),81、2周时这种情况继续改善。结论依那西普可以迅速改善JSpA的症状和体征,降低疾病活动度,对难治性髋关节病变疗效确切并未见明显不良反应。
Objective To evaluate the clinical efficacy and safety of Etanercept in the treatment of hip joint disease associated with refractory juvenile spondyloarthropathy（JSpA）.Methods All patients in the study diagnosed as JSpA according to the classification criteria of European Spondyloarthropathy（ESSG,1991）.And all patients were younger than 16 years old,with the involvement of unilateral or bilateral hip joints.Those with poor response to NSAIDs or traditional DMARDs were selected and given Etanercept 0.8 mg/kg subcutaneously once or twice a week for 12 weeks.The hip joint score,number of involved peripheral joints in arthritis,number of enthesitis,platelet count（PLT）,as well as indicators of inflammatory reaction such as erythrocyte sedimentation rate（ESR） and C reactive protein（CRP）,were evaluated at week 0,4,8,12,respectively.The patients were followed up for 36 weeks to observe their condition during reduction,maintenance and withdraw of Etanercept.The adverse events were recorded.Results All of the 23 patients completed 12 weeks of observation,and the hip joint score decreased after 4 weeks,numbers of arthritis and enthesitis reduced and significant difference was found when compared with their baseline levels（P0.05）.The condition improved further at week 8 and 12.Conclusion Etanercept can promptly improve the signs and symptoms of JSpA.It has definite efficacy in the treatment of refractory hip diseases.Reducing the dosing frequency of Etanercept can maintain the efficacy and decrease side effects.
出处
《宁夏医学杂志》
CAS
2011年第11期1049-1051,共3页
Ningxia Medical Journal
关键词
肿瘤坏死因子
幼年
脊柱关节病
髋关节
Tumor necrosis factor
Juvenile
Spondyloarthropathies
Hip joint
