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关节腔内注射倍他米松和玻璃酸治疗老年膝骨关节炎的临床观察
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| 篇名： | 关节腔内注射倍他米松和玻璃酸治疗老年膝骨关节炎的临床观察 |
| TITLE： | |
| 摘要： | 目的：观察关节腔内注射倍他米松和玻璃酸治疗老年膝骨关节炎的临床疗效及安全性。方法：选取我院2012年7月－2015年7月收治的老年膝骨关节炎患者76例，以随机数字表法分为对照组和观察组，各38例。对照组患者给予关节腔内注射玻璃酸钠注射液2 mL，每周1次，连用3周；观察组患者第1周给予复方倍他米松注射液1 mL，后两周给予玻璃酸钠注射液，每次2 mL，每周1次。比较两组患者的临床疗效和不良反应发生情况，以及治疗前后的视觉模拟评分法（VAS）评分、西安大略和麦克马斯特大学骨关节炎量表（WOMAC）评分、生活质量综合评定问卷（GQOLI-74）评分和基质金属蛋白酶（MMP）水平。结果：观察组患者的总有效率为92.11％，显著高于对照组的73.68％，差异有统计学意义（P＜0.05）。治疗前，两组患者的VAS、WOMAC、GQOLI-74评分和MMP-1、MMP-3水平比较，差异均无统计学意义（P＞0.05）；治疗后，两组患者的VAS、关节僵硬、关节疼痛和日常活动受限评分，以及MMP-1、MMP-3水平均较治疗前显著下降，躯体疼痛、生理功能、生理职能、活力、社会功能、情感职能、精神健康及GQOLI-74总评分均较治疗前显著升高，且观察组各指标显著优于对照组，差异均有统计学意义（P＜0.05）。两组患者在治疗过程中均未见严重的不良反应发生。结论：关节腔内注射倍他米松和玻璃酸治疗老年膝骨关节炎可有效降低疼痛程度、改善膝关节功能、提高患者生活质量，临床疗效较好且安全性较高，其机制有可能是降低了患者膝关节的MMP水平而获益。 |
| ABSTRACT： | OBJECTIVE： To observe clinical efficacy and safety of intraarticular injection of betamethasone and hyaluronate in the treatment of elderly knee osteoarthritis. METHODS： A total of 76 elderly patients with knee osteoarthritis were selected from our hospital during Jul. 2012 to Jul. 2015， and then divided into control group and observation group according to random number table， with 38 cases in each group. Control group was given intraarticular injection of Sodium hyaluronate injection 2 mL， once a week， for consecutive 3 weeks. Observation group was given Compound betamethasone injection 1 mL in the first week， and given sodium hyaluronate 2 mL， every week， in the following 2 weeks. Clinical efficacies and the occurrence of ADR as well as VAS score， WOMAC score， GQOLI-74 score and MMP levels before and after treatment were compared between 2 groups. RESULTS： Total response rate of observation group was 92.11％， which was significantly higher than 73.68％ of control group， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in VAS score， WOMAC score， GQOLI-74 score， MMP-1 level or MMP-3 level between 2 groups （P＞0.05）. After treatment， VAS， joint stiffness， joint pain and daily activity restriction score as well as MMP-1， MMP-3 were decreased significantly in 2 groups， compared to before treatment； physical pain， physiological function， physiological limitations， vitality， social function， emotional function， mental health and GQOLI-74 total score were increased significantly， and the each index of observation group was significantly better than that of control group， with statistical significance （P＜0.05）. No obvious ADR was found in 2 groups during treatment. CONCLUSIONS： The intraarticular injection of betamethasone and sodium hyaluronate in the treatment of elderly knee osteoarthritis can effectively reduce pain degree， improve knee function and quality of life， have good therapeutic efficacy and safety， the mechanism of which may be associated with the reduction of MMP level. |
| 期刊： | 2017年第28卷第26期 |
| 作者： | 陈献锦，陈元良，王辉敏 |
| AUTHORS： | CHEN Xianjin，CHEN Yuanliang，WANG Huimin |
| 关键字： | 倍他米松；玻璃酸；关节腔内注射；膝骨关节炎 |
| KEYWORDS： | Betamethasone； Hyaluronate； Intraarticular injection； Knee osteoarthritis |
| 阅读数： | 500 次 |
| 本月下载数： | 3 次 |
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