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目的通过单中心较大样本的X线检查及临床分析,了解我国血友病骨关节病的治疗现状。方法回顾性分析101例血友病患者的临床资料和骨关节的放射学积分。结果①患者首次发生异常出血和首次就诊的中位年龄分别为1岁和15岁,诊断时间延迟。②骨关节病在重型、中型、轻型血友病的发生率分别为77.8%、53.6%、20.0%,中型、轻型患者也有较高的罹患率。易受累的关节依次为膝、肘、踝;③在0~9岁、10~19岁、20~29岁、30~39岁、40~49岁、≥50岁等各年龄段,骨关节病的发病率分别为37.5%、59.4%、78.3%、83.3%、76.9%、100%。④治疗组和非治疗组骨关节病的发病率分别为69.4%和62.1%,差异无显著性;⑤骨关节畸形的发生率在具有靶关节组和无靶关节组分别为71.2%和20.0%,差异有显著性。结论我国血友病患者骨关节病发病率高,成为影响患者健康相关生活质量的主要因素之一。靶关节可以作为判断发生病变骨关节预后的较好指标。
Objective To understand the current treatment of osteoarthritis of hemophilia in our country through the X-ray examination and clinical analysis of large single center samples. Methods A retrospective analysis of 101 cases of hemophilia patients with clinical data and bone and joint radiological scores. Results ① The median age at first occurrence of abnormal bleeding and first visit was 1 year and 15 years respectively, and the diagnosis time was delayed. ② The incidence of osteoarthrosis in severe, moderate and mild haemophilia was 77.8%, 53.6% and 20.0% respectively. The moderate and light type patients also had a higher attack rate. Easily affected joints followed by knee, elbow, ankle; ③ in 0 to 9 years old, 10 to 19 years old, 20 to 29 years old, 30 to 39 years old, 40 to 49 years old, ≥ 50 years old and other age groups, osteoarthritis The incidence rates were 37.5%, 59.4%, 78.3%, 83.3%, 76.9%, 100% respectively. ④ The incidence of osteoarthropathy in treatment group and non-treatment group were 69.4% and 62.1% respectively, with no significant difference; ⑤ The incidence of osteoarthropathy was 71.2% and 20.0% in the group with and without target joint, respectively , The difference was significant. Conclusion The incidence of osteoarthropathy in hemophilia patients in our country is high and has become one of the main factors affecting the quality of life of patients with hemophilia. The target joint can be used as a good indicator to judge the prognosis of the diseased bone and joint.