^32P-磷酸铬胶体滑膜切除术联合常规药物治疗强直性脊柱炎髋关节病变

^32P-chromic phosphate colloidal synovectomy combined with routine medication treating the hip disease of ankylosing spondylitis

目的观察，^32P-磷酸铬胶体滑膜切除术联合常规药物治疗强直性脊柱炎髋关节病变的疗效。方法强直性脊柱炎单侧髋关节病变住院患者84例，分别人组常规药物联合^32P-酸铬胶体滑膜切除术组（联合治疗组）和单用常规药物组（对照组）各42例，观察其疗效和安全性。结果随访6个月，联合治疗组和对照组有效率分别为73．8％和52．4％，联合治疗组显著优于对照组（X^2=4．840，P〈0．05）；随访3年，有效率分别为53．8％和47．6％，两组比较无统计学意义（X^2=0．047，P〉0．05）。随访3年髋关节x线分期出现进展，联合治疗组与对照组比较差异显著（X^2=5．516，P〈0．05）。随访6个月及随访3年，联合治疗组和对照组分别与治疗前Bath强直性脊柱炎病情活动指数（BAS-DAI）评分的差值比较，差异均无统计学意义（t=1．303，19〉0．05及t=1．759，P〉0．05）。随访6个月，联合治疗组和对照组的髋关节视觉模拟评分（VAS）与治疗前的差值比较差异显著（t=2．389，P〈0．05），而随访3年，联合治疗组和对照组的髋关节VAS评分与治疗前的差值比较，其差异无统计学意义（t=1．632，P〉0．05）。不良反应仅见5例出现一过性关节疼痛加重。结论^32P-磷酸铬胶体滑膜切除术联合常规药物治疗强直性脊柱炎髋关节病变有一定近期疗效。

Objective To observe the therapeutic effect of 3~p-chromic phosphate colloidal syn- ovectomy combined with routine medication in the treatment of the hip disease of ankylosing spondylitis. Method Eight-two ankylosing spondylitis unilateral hip patients were divided into two groups. Forty-two were enrolled in the routine medication combined with 32p-chromic phosphate colloidal synovectomy group （treatment group） and 42 in conventional medicine group（control group）. The efficacy and safety were observed. Resuts The effective rate of treatment group and control group were 73.8% and 52.4% respectively in the following six months. The difference was significant （X^2=4.840, P〈0.05）. The effective rate were respectively 53.8% and 47.6% in three-year follow-up, with no significant difference between the two groups （X^2=0.047 ,P〉0.05 ）. There was progress on the X-ray phases of hip joint in three-year follow-up, for the difference between the treatment group and the control group was significant （X^2=5.516,P 〈0.05）. During the different follow-up time, six months and three years, there were differences in Bath Ankylosing Spondylitis Disease Activity Index （BASDAI） before and after treatment between the treatment group and the control group, but the differences were not statistically significant （ t=1.303, t=1.759, P all〉0.05 ）. When followed up for 6 months, the differences in the visual analogue scale（VAS） for hip of the treatment group and the control group were statistically different between before and after treatment（t=2.389, P〈0.05 ）. But when followed up for three years, the differences were not statistically different （t=1.632, P〉0.05）. The side effects was oh served only in five cases which was transient pain increase in joints. Conclusion 32P-chromic phos- phate colloid synovectomy combined with routine medication had a short-term effect in treating the hip joint disease of ankylosing spondylitis.