局部应用依那西普治疗强直性脊柱炎髋关节受累的临床疗效分析

目的：评价局部应用依那西普治疗强直性脊柱炎髋关节受累的短期疗效。方法：选择我科2001-2011年收治的强直性脊柱炎髋关节受累的患者50例，在高频超声引导下于髋关节局部注射依那西普50mg，每周1次，连用4次。分别在注射前、注射后2、4、8周观察患者的BASDAI、BASFI、脊柱痛VAS、患者总体评价（PGA）VAS、夜间痛VAS、血沉、CRP和Harris功能评分，同时记录患者出现的不良反应。结果：依那西普治疗2周时，30例达ASAS20的缓解（60％），13例（26％）达到ASAS50的缓解，8例（16％）达到ASAS70的缓解；治疗8周时，ASAS20／50／70的缓解率分别为38例（64％）、21例（42％）、15例（30％），其中Harris评分达70以上者占总人数的90％，80分60％，90分30％，1例患者缓解不明显，4例患者处于70分以下，但疾病活动度情况改善。结论：依那西普可有效改善强直性脊柱炎髋关节受累患者的关节症状，降低疾病活动强度，且无明显药物不良反应。

Clinical Efficacy of Etanercept hip joint Injection in the Treatment of Patients with Ankylosing Spondylitis＊

Objective： To evaluate the short-term efficacy of etanercept hip joint injection in the treatment of patients with anky- losing spondylitis. Methods： 50 cases with ankylosing spondylitis admitted in our hospital from 2001 to 2011 were injected into hip joint with etanercept 50 mg once a week for a treatment course of 4 weeks under the high-frequency ultrasound. The Bath Ankylosing Spondylitis Functional Index （BASFI）, Bath Ankylosing Spondylitis Disease Activity Index （BASDAD, spinal pain VAS, （FGA）VAS, nocturnal spinal pain VAS, ESR, C-reactive protein （CRP）, Harris and possible adverse reaction were observed at week 0, 2, 4, 8 respec- tively. Results： Compared with the baseline, the observation items were all significantly improved after 2, 4 and 8 weeks＇ treatment. At 2nd week, 60%（n=30）, 26%（n=13） and 16%（n=8） of the patients achieved ASAS20, ASAS50 and ASAS70, respectively. At 8th week, the percentage of patients achieving the ASAS20/50/70 were 64%（n=38）, 42%（n=21）, 30%（n=15）respectively. The percentage of re spon- ders, above 70 of Harris was 90%, above 80 was 60%, and above 90 was 30%. 1 patient had no improvement. And there were 4 patients below 70, but had recuding clinical signs. Conclusion： Etanercept was clinically effective and well tolerated in the treatment of AS pa- tients, which could provide fast action, reduce clinical signs and improve range of motion as well as quality of life.