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目的观察关节腔注射曲安奈德、益赛普对类风湿性关节炎(RA)所致膝关节炎的疗效和安全性。方法选取RA合并膝关节肿痛患者90例,随机分为A组、B组、C组各30例,分别于关节腔注射曲安奈德、益赛普、曲安奈德联合益赛普,分别于治疗后1周、1月、2月、3月末观察血沉、CRP、关节疼痛指数、压痛指数、滑膜厚度、滑膜血流信号等评价治疗效果,同时记录治疗过程中有无不良反应发生。结果与治疗前相比,治疗后3组血沉、CRP、关节疼痛指数、压痛指数、滑膜厚度、滑膜血流信号等均明显改善;A组从2月末时血沉、CRP、关节疼痛指数评分、压痛指数评分、滑膜厚度、滑膜血流信号等较上月无明显改善,而B组、C组上述指标较上月比较均持续改善。组间比较,从2月末开始,B组上述指标改善优于A组,而C组从治疗开始上述指标改善持续优于A组、B组。治疗过程中均未见严重不良反应。结论关节腔注射曲安奈德、益赛普是一种安全有效的控制RA局部及全身炎性反应的方法,联合用药优于单独用药。
Objective To observe the curative effect and safety of intra-articular injection of triamcinolone acetonide and imatinib on knee arthritis induced by rheumatoid arthritis (RA). Methods Totally 90 RA patients with knee pain were selected and randomly divided into group A, group B and group C, 30 cases each. Triamcinolone acetonide, triamcinolone acetonide and triamcinolone acetonide Erythrocyte sedimentation rate, CRP, joint pain index, tenderness index, synovial thickness and synovial flow signals were evaluated at 1 week, 1 month, 2 months and 3 months after treatment, and the adverse reactions were recorded during the treatment. Results Compared with those before treatment, the erythrocyte sedimentation rate, CRP, joint pain index, tenderness index, synovial thickness and synovial flow signal of the three groups were significantly improved after treatment. In group A, the ESR, CRP, , Tenderness index score, synovial thickness, synovial blood flow signal and other no significant improvement over the previous month, while the B group, C group of the above indicators continued to improve over the previous month. From the end of February, the improvement of the above indexes in group B was better than that of group A, and the improvement of the above indexes in group C continued to be superior to that of group A and group B from the beginning of February. No serious adverse reactions during the treatment. Conclusion Intra-articular injection of triamcinolone acetonide and etanercept is a safe and effective method to control local and systemic inflammation of RA. Combination therapy is superior to that of triamcinolone acetonide alone.