摘要
目的探讨肿瘤坏死因子α（TNF-α）拮抗剂治疗难治性SAPHO综合征（synovitis,acne,pustulosis,hyperostosisand and osteitis）的疗效及安全性。方法回顾分析35例难治性SAPHO综合征患者使用TNF-α拮抗剂治疗情况,记录患者治疗的反应。结果 35例患者应用TNF-α拮抗剂治疗时间为2～240周,平均（24.4±48.8）周。初期对骨痛有明显改善32例（91.4%）,其中接受1次治疗后骨痛有改善22例（68.8%）;接受2次治疗后骨痛改善8例（32.0%）;接受3次治疗后骨痛改善2例（6.2%）。初期对皮疹有效15例,但在维持治疗中因停药或减量皮疹复发或加重6例;对皮疹无改善12例;出现新发皮疹6例。出现不良反应9例：出现新发皮疹6例、出现颌下腺炎1例、出现臀部脓肿1例、出现肺炎1例。结论难治性SAPHO综合征患者接受TNF-α拮抗剂治疗,初期对骨痛有明显改善32例（91.4%）,多在前3次治疗中起效;但维持用药中只有11例（31.4%）有效;对皮疹的改善多不满意,只有9例（27.2%）有效,并且有可能诱发新发皮疹或皮疹加重,同时存在潜在感染的风险。
Objective To investigate the efficacy and safety of anti-tumor necrosis factor alpha（TNF-α）antagonist in the treatment of refractory SAPHO syndrome（synovitis,acne,pustulosis,hyperostosis and osteitis）.Methods A total of 35 patients with refractory SAPHO syndrome treated by TNF-αantagonist was retrospectively studied and the response of patients was recorded.Results The treatment time for 35 patients with TNF-αantagonist was 2weeks to 240 weeks,and the average time was（24.4±48.8）weeks.The ostalgia in 32cases（91.4%）significantly improved in the early time：the ostalgia in 22cases（68.8%）has been improved after receiving once therapy;the ostalgia in 8cases（32.0%）improved after receiving twice therapy;the ostalgia in 2cases（6.2%）improved after receiving therapy three times.For rash,15 cases were effective in early stage,but in the maintenance treatment,6cases had a relapse or aggravation of skin rash and 12 cases had no improvement.A total of 9cases had adverse reactions：6cases had new rash,1case had submaxillaritis,1case had buttock abscess and 1case had pneumonia.Conclusion Among the patients with refractory SAPHO syndrome receiving TNF-αantagonist treatment,91.4% of patients with ostalgia significantly improved in the early time and the improvement was more effective in the first three therapy;but in the maintenance medication,only 11cases（31.4%）were effective.The improvement of the rash was not wholly satisfied,only 9cases（27.2%）were effective and it was possible to induce a new or aggravated rash,and also there was potential risk to be infected.
出处
《临床荟萃》
CAS
2016年第1期45-47,52,共4页
Clinical Focus
关键词
获得性骨肥大综合征
肿瘤坏死因子Α
治疗结果
疹
acquired hyperostosis syndrome
tumor necrosis factor-alpha
treatment outcome
exanthema
