超声引导下关节腔内注射重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(益赛普)治疗血友病性关节病

Ultrasound-guided intra-articular injection of recombinant human tumor necrosis factor receptor-Fc fusion protein(etanercept)for treating hemophilic arthropathy

目的观察超声引导下关节腔内注射重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(益赛普)治疗血友病性关节病(HA)的价值。方法回顾性分析32例接受超声引导下穿刺关节腔注射益赛普的HA患者,对比观察治疗前及治疗后1个月血友病关节健康评分(HJHS)、视觉模拟评分(VAS),以及超声所示目标关节增生滑膜厚度、血流信号、Melchiorre及中国早期血友病性关节病超声检测(HEAD-US-C)评分,评估其治疗价值。结果对32例均成功完成超声引导下穿刺关节腔及腔内注射益赛普,共对18例膝关节、7例肘关节及7例踝关节进行治疗。术后未出现感染、出血等并发症。治疗后1个月,目标关节HJHS、VAS、Melchiorre评分、HEAD-US-C评分及增生滑膜最大厚度、平均厚度、血流信号均低于治疗前(P均<0.01)。结论超声引导下关节腔内注射益赛普治疗HA安全、有效。

Objective To observe the value of ultrasound-guided intra-articular injection of recombinant human tumor necrosis factor receptor-Fc fusion protein(etanercept)for treating hemophilic arthropathy(HA).Methods Data of 32 HA patients who underwent ultrasound-guided intra-articular injection of etanercept were retrospectively analyzed.The hemophilia joint health scores(HJHS),visual analogue scale(VAS),the thickness and blood flow signals of proliferative synovial membrane,Melchiorre scale,hemophilic early arthropathy detection with ultrasound in China(HEAD-US-C)score of target joints before and 1 month after treatment were observed and compared.The value of ultrasound-guided intra-articular injection of etanercept for treating HA was analyzed.Results Ultrasound-guided percutaneous intra-articular injection of etanercept was successfully completed in all 32 cases,including keen joint of 18 cases,elbow joint of 7 cases and ankle join of 7 cases.No complication such as infection and bleeding occurred.One month after treatment,the HJHS,VAS,Melchiorre scale,HEAD-US-C scores,and the maximum thickness,the average thickness and blood flow signals of proliferative synovial membrane of target joint were all lower than those before treatment(all P<0.01).Conclusion Ultrasound-guided intra-articular injection of etanercept was safe and effective for treatment of HA.