半剂量依那西普联合甲氨蝶呤治疗强直性脊柱炎髋关节病变的临床观察

目的观察半剂量依那西普联合甲氨蝶呤治疗强直性脊柱炎（AS）髋关节病变的疗效。方法对25例伴单侧或双侧髋关节受累的AS患者给予半剂量依那西普25mg，皮下注射，每周1次，持续12周，并联合甲氨蝶呤15mg，口服或皮下注射，每周1次。观察参数包括治疗前后的Harris髋关节评分、AS疾病活动度评分（ASDAS）和BathAS髋关节X线指数（BASRI—hip）。结果25例患者中共33个髋关节受累，其治疗前Harris髋关节评分为（50．79±14．52）分，治疗12周后评分明显上升为（79．97±15．54）分（P〈0．01）；治疗前ASDAS评分为（4．76±0．69）分，治疗12周后明显下降为（2．62±0．50）分（P〈0．01）；而BASRI—hip治疗前后无明显改变。本研究治疗和随访过程中患者未出现结核和其他严重感染。结论半剂量依那西普联合甲氨蝶呤治疗AS相关髋关节病变有效，未见明显不良反应。

Half-value dose Etanercept combined with Methotrexate in the therapy of hip joint lesion of ankylosing spondylitis

Objective To observe the therapeutic effect of half-value dose Etanercept combined with Methoterxate(MTX) in hip joint lesion of ankylosing spondylitis(AS).Methods Twenty-five patients with AS with unilateral or bilateral hip joint lesion were enrolled in the study.These patients received Etanercept 25 mg injected subcutaneously once a week for 12 weeks,combined with MTX 15 mg once a week administrated orally or subcutaneously.Parameters observed included Harris hip score,ankylosing spondylitis disease activity score(ASDAS),Bath ankylosing spondylitis radiologic index-hip(BASRI-hip) before and after the treatment.Results Thirty-three hip joints were enrolled in 25 patients.Harris hip score were elevated significantly from(50.79±14.52) before treatment to(79.97±15.54) after treatment(P < 0.01) while ASDAS declined from(4.76±0.69) to(2.62±0.50)(P < 0.01).But there was no change in BASRI-hip before and after treatment.During the treatment and follow-up period,no tuberculosis or severe infection was observed.Conclusion Half-value dose Etanercept combined with Methotrexate is effective in treating hip joint lesion of AS without serious side effects.