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目的:评价局部应用依那西普治疗强直性脊柱炎髋关节受累的短期疗效。方法:选择我科2001-2011年收治的强直性脊柱炎髋关节受累的患者50例,在高频超声引导下于髋关节局部注射依那西普50 mg,每周1次,连用4次。分别在注射前、注射后2、4、8周观察患者的BASDAI、BASFI、脊柱痛VAS、患者总体评价(PGA)VAS、夜间痛VAS、血沉、CRP和Harris功能评分,同时记录患者出现的不良反应。结果:依那西普治疗2周时,30例达ASAS20的缓解(60%),13例(26%)达到ASAS50的缓解,8例(16%)达到ASAS70的缓解;治疗8周时,ASAS20/50/70的缓解率分别为38例(64%)、21例(42%)、15例(30%),其中Harris评分达70以上者占总人数的90%,80分60%,90分30%,1例患者缓解不明显,4例患者处于70分以下,但疾病活动度情况改善。结论:依那西普可有效改善强直性脊柱炎髋关节受累患者的关节症状,降低疾病活动强度,且无明显药物不良反应。
OBJECTIVE: To evaluate the short-term efficacy of topical application of etanercept in the treatment of hip joint involvement in ankylosing spondylitis. Methods: Fifty patients with hip involvement in ankylosing spondylitis admitted from 2001 to 2011 in our department were enrolled. Fifty mg of etanercept was injected locally to the hip joint under the guidance of high-frequency ultrasound four times a week. The patients’ BASDAI, BASFI, spine pain VAS, PGA VAS, nocturnal pain VAS, erythrocyte sedimentation rate, CRP and Harris function scores were observed before injection and 2, 4, and 8 weeks after injection, reaction. Results: After 2 weeks of treatment with etanercept, 30 patients achieved ASAS20 remission (60%), 13 patients (26%) achieved ASAS50 remission and 8 patients (16%) achieved ASAS70 remission. At 8 weeks, ASAS20 / 50/70 were 38 cases (64%), 21 cases (42%) and 15 cases (30%), respectively. The Harris score of 70 or more accounted for 90%, 80%, 60% 30%, 1 patient was not significantly alleviated, 4 patients were below 70 points, but the disease activity improved. Conclusion: Etanercept can effectively improve the joint symptoms of patients with hip joint involvement in ankylosing spondylitis, reduce the intensity of disease activity, and no obvious adverse drug reactions.