关节腔注射重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白联合复方倍他米松治疗类风湿关节炎膝关节炎的临床观察

目的评价关节腔注射重组人Ⅱ型肿瘤坏死因子受体- 抗体融合蛋白联合复方倍他米松对类风湿关节炎膝关节炎的疗效及安全性.方法：对具有膝关节炎的24 例类风湿关节炎患者行膝关节腔穿刺,注入重组人Ⅱ型肿瘤坏死因子受体- 抗体融合蛋白25 mg与复方倍他米松7 mg,注射前及注射后4 周与8 周评估关节病变情况.结果：注射治疗4 周与8 周后患者关节疼痛评分、肿胀指数、压痛指数均较治疗前明显改善,差异具有统计学意义（P 〈 0.05）;治疗前、治疗后4 周及治疗后8 周患者膝关节平均滑膜厚度分别为（6.7 ± 2.0）、（5.8 ± 2.2）、（4.2 ± 2.3） mm,膝关节滑膜增厚明显减轻,治疗前与治疗后4 周乃至8 周比较,差异具有统计学意义（P 〈 0.05）.结论：关节腔注射重组人Ⅱ型肿瘤坏死因子受体- 抗体融合蛋白联合复方倍他米松可减轻关节炎症,安全性较好.

The effect of intra-articular injection of recombinant human tumor necrosis factor-Fc and compoundbetamethasone in knee in patients with rheumatoid arthritis

Objective： To evaluate the efficacy and safety of intra-articular injection of recombinant human tumor necrosisfactor-Fc and compound betamethasone in patients with knee arthritis of rheumatoid arthritis （RA）. Methods： A total of 24patients with knee arthritis of RA were intra-articular injected recombinant human tumor necrosis factor-Fc 25 mg and compoundbetamethasone 7 mg. Visual analogue scale （VAS）, swelling scores, tenderness scores, the thickness of synovium were recorded andanalyzed at 4-week as well as 8-week treatment after injection compared with pre-treatment. Results： Compared with that of pretreatment,the VAS, swelling scores, and tenderness scores significantly improved after treatment for 4 weeks and 8 weeks （P 〈 0.05）.The average thickness of synovium in knee at 4-week and 8-week treatment were （5.8 ± 2.2） mm, （4.2 ± 2.3） mm respectively, whichshowed significant differences compared with that of pre-treatment （6.7 ± 2.0） mm （P 〈 0.05）. Conclusion： Intra-articular injectionof recombinant human tumor necrosis factor-Fc and compound betamethasone is an effective and safe therapy for refractory kneearthritis of RA.