膝关节腔注射透明质酸钠对成人大骨节病患者生存质量的影响

The improvement of quality life of intro-articular hyaluronic acid on adults with Kashin-Beck disease

目的 评价膝关节腔注射透明质酸钠后,大骨节病患者的生存质量改善状况.方法 选择陕西省永寿县大骨节病患者50例,膝关节腔内注射透明质酸钠（25 mg）,每周注射1次,连续注射4周.在治疗前后,采用健康状况调查问卷（SF-36量表）调查患者的生存质量,并计算大骨节病患者治疗2个月后质量调整生命年（QALY）.结果 大骨节病患者膝关节腔注射透明质酸钠后,患者的生存质量总评分由治疗前的38.81±17.39上升到治疗后的49.35±17.95.SF-36量表的8个测量维度中生理机能（PF）、躯体疼痛（BP）、一般健康状况（GH）、精力（VT）、社会功能（SF）和精神健康（MH）在治疗1周后的评分分别为54.42±21.25、47.42±20.80、48.00±26.12、61.05±19.14、68.09±28.73和68.74±14.85,均高于治疗前（41.51±22.11、27.63±11.78、38.76±25.14、51.97±18.14、57.89±30.95、56.95±20.47,t=-3.942、-6.344、-2.494、-2.785、-2.819、-4.245,P均＜0.05）.治疗后随访2个月,大骨节病患者QALY提高0.051±0.044.结论 膝关节腔注射透明质酸钠能显著提高大骨节病患者的生存质量（生理机能、躯体疼痛、一般健康状况、精力、社会功能、精神健康）.

Objective To investigate the improvement of quality of life of patient with Kashin-Beck disease （KBD） after knee joint cavity injection of hyaluronic acid.Methods Fifty KBD patients were selected in Yongshou County Shaanxi Province,and accepted knee joint cavity injection of hyaluronic acid （25 mg） for four times,one time a week.SF-36 health questionnaire was used to evaluate the quality of life of KBD patients,and the quality adjusted life years （QALYs） were calculated after 2 months.Results The total score of the quality of life of KBD patients was improved from 38.81 ± 17.39 to 49.35 ± 17.95 after knee joint cavity injection of hyaluronic acid.The scores of physiological function （PF）,body pain （BP）,general health （GH）,energy （VT）,social function （SF） and mental health （MH） in the eight dimensions of SF-36 scale were 54.42 ± 21.25,47.42 ± 20.80,48.00 ± 26.12,61.05 ± 19.14,68.09 ± 28.73 and 68.74 ± 14.85,respectively,after the treatment,which were higher than those before the treatment （41.51 ± 22.11,27.63 ± 11.78,38.76 ± 25.14,51.97 ± 18.14,57.89 ± 30.95 and 56.95 ± 20.47,t =-3.942,-6.344,-2.494,-2.785,-2.819 and-4.245,all P 〈 0.05）.The QALYs of KBD patients increased 0.051 ± 0.044 with 2 months followed up.Conclusion The quality of life （PF,BP,GH,VT,SF and MH） of KBD patients could be significantly improved after knee joint cavity injection of hyaluronic acid.