依那西普联合甲氨喋呤治疗膝关节类风湿性滑膜炎的超声声像图分析

发布时间：2018-05-16 18:38

本文选题：类风湿关节炎 + 滑膜炎　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：探讨生物制剂依那西普联合甲氨喋呤治疗类风湿性关节炎（RA）对关节滑膜炎疗效及彩色多普勒超声对疗效的评估价值。方法：选择2012年12月-2013年8月在本院风湿科住院的膝关节类风湿性滑膜炎患者60例，随机分为2组，治疗组30例，使用生物制剂依那西普药物联合甲氨喋呤治疗，，对照组30例，使用甲氨蝶呤单独治疗。观察两组病人治疗前、治疗后的超声观察指标（包括膝关节的髌上囊积液深度、滑膜厚度、滑膜血管分级等）以及生化指标（血沉、C反应蛋白等）。结果：1.超声指标，与对照组比较，治疗组髌上囊积液深度减少、滑膜厚度变薄、滑膜内血管阻力指数增高、滑膜内血管分级减低，差异显著，有统计学意义（P0.05）。2.生化指标，与对照组比较，治疗组患者血沉降低，C反应蛋白增加，差异显著，有统计学意义（P0.05）。3.相关性分析显示，血沉浓度与髌上囊积液厚度、滑膜厚度、滑膜血管分级、滑膜血管RI有一定的相关性，r分别为0.52、0.49、0.63、-0.44。C反应蛋白浓度与髌上囊积液深度、滑膜厚度、滑膜血管分级、滑膜血管RI有一定的相关性，r分别为0.44、0.36、0.53、-0.46。结论：生物制剂依那西普联合甲氨喋呤治疗类风湿性关节炎（RA）对关节滑膜炎疗效较单独使用甲氨蝶呤疗效显著。彩色多普勒超声能够直观且准确的评价关节滑膜炎的疗效，可成为不可替代的临床观察手段。
[Abstract]:Objective: to evaluate the efficacy of Einacetin combined with methotrexate in the treatment of rheumatoid arthritis (RA) and the value of color Doppler ultrasound (CDFI) in the evaluation of synovitis. Methods: from December 2012 to August 2013, 60 patients with rheumatoid synovitis of knee joint were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). Use methotrexate alone. The ultrasonic parameters (including the depth of suprapatellar sac fluid, synovial thickness, synovial vascular grading, etc.) and biochemical indexes (ESR C reactive protein) were observed before and after treatment in the two groups. The result is 1: 1. Compared with the control group, in the treatment group, the depth of the suprapatellar sac effusion decreased, the synovial thickness became thinner, the vascular resistance index in the synovium increased, and the grade of the intrasynovial blood vessel decreased, the difference was significant (P 0.05 路2). Compared with the control group, the ESR of the treatment group decreased the level of C reactive protein increased significantly, the difference was significant (P 0.05. 3). Correlation analysis showed that ESR concentration was correlated with the thickness of suprapatellar sac effusion, the grading of synovial vessels, RI of synovial vessels, and the concentration of reactive protein (RRP) was 0.52 ~ 0.49 ~ 0.63U -0.44.C, respectively, and the thickness of synovium and the grading of synovial vessels were also found to be related to the concentration of ESR, the thickness of synovial membrane, and the grading of synovial vessels. The RI of synovial vessels was 0. 44 ~ 0. 36 ~ 0. 53 ~ 0. 46 respectively. Conclusion: the therapeutic effect of enazepine combined with methotrexate in the treatment of rheumatoid arthritis is more effective than that of methotrexate alone in the treatment of synovitis. Color Doppler ultrasound can directly and accurately evaluate the curative effect of synovitis and become an irreplaceable clinical observation method.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R593.22;R445.1

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