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

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。

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

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.