本文選題：類風濕關(guān)節(jié)炎 + 滑膜炎�。� 參考：《新疆醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討生物制劑依那西普聯(lián)合甲氨喋呤治療類風濕性關(guān)節(jié)炎（RA）對關(guān)節(jié)滑膜炎療效及彩色多普勒超聲對療效的評估價值。方法：選擇2012年12月-2013年8月在本院風濕科住院的膝關(guān)節(jié)類風濕性滑膜炎患者60例，隨機分為2組，治療組30例，使用生物制劑依那西普藥物聯(lián)合甲氨喋呤治療，，對照組30例，使用甲氨蝶呤單獨治療。觀察兩組病人治療前、治療后的超聲觀察指標（包括膝關(guān)節(jié)的髕上囊積液深度、滑膜厚度、滑膜血管分級等）以及生化指標（血沉、C反應(yīng)蛋白等）。結(jié)果：1.超聲指標，與對照組比較，治療組髕上囊積液深度減少、滑膜厚度變薄、滑膜內(nèi)血管阻力指數(shù)增高、滑膜內(nèi)血管分級減低，差異顯著，有統(tǒng)計學(xué)意義（P0.05）。2.生化指標，與對照組比較，治療組患者血沉降低，C反應(yīng)蛋白增加，差異顯著，有統(tǒng)計學(xué)意義（P0.05）。3.相關(guān)性分析顯示，血沉濃度與髕上囊積液厚度、滑膜厚度、滑膜血管分級、滑膜血管RI有一定的相關(guān)性，r分別為0.52、0.49、0.63、-0.44。C反應(yīng)蛋白濃度與髕上囊積液深度、滑膜厚度、滑膜血管分級、滑膜血管RI有一定的相關(guān)性，r分別為0.44、0.36、0.53、-0.46。結(jié)論：生物制劑依那西普聯(lián)合甲氨喋呤治療類風濕性關(guān)節(jié)炎（RA）對關(guān)節(jié)滑膜炎療效較單獨使用甲氨蝶呤療效顯著。彩色多普勒超聲能夠直觀且準確的評價關(guān)節(jié)滑膜炎的療效，可成為不可替代的臨床觀察手段。
[Abstract]:Objective: to evaluate the efficacy of Einacetin combined with methotrexate in the treatment of rheumatoid arthritis (RA) and the value of color Doppler ultrasound (CDFI) in the evaluation of synovitis. Methods: from December 2012 to August 2013, 60 patients with rheumatoid synovitis of knee joint were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). Use methotrexate alone. The ultrasonic parameters (including the depth of suprapatellar sac fluid, synovial thickness, synovial vascular grading, etc.) and biochemical indexes (ESR C reactive protein) were observed before and after treatment in the two groups. The result is 1: 1. Compared with the control group, in the treatment group, the depth of the suprapatellar sac effusion decreased, the synovial thickness became thinner, the vascular resistance index in the synovium increased, and the grade of the intrasynovial blood vessel decreased, the difference was significant (P 0.05 路2). Compared with the control group, the ESR of the treatment group decreased the level of C reactive protein increased significantly, the difference was significant (P 0.05. 3). Correlation analysis showed that ESR concentration was correlated with the thickness of suprapatellar sac effusion, the grading of synovial vessels, RI of synovial vessels, and the concentration of reactive protein (RRP) was 0.52 ~ 0.49 ~ 0.63U -0.44.C, respectively, and the thickness of synovium and the grading of synovial vessels were also found to be related to the concentration of ESR, the thickness of synovial membrane, and the grading of synovial vessels. The RI of synovial vessels was 0. 44 ~ 0. 36 ~ 0. 53 ~ 0. 46 respectively. Conclusion: the therapeutic effect of enazepine combined with methotrexate in the treatment of rheumatoid arthritis is more effective than that of methotrexate alone in the treatment of synovitis. Color Doppler ultrasound can directly and accurately evaluate the curative effect of synovitis and become an irreplaceable clinical observation method.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R593.22;R445.1

【參考文獻】

相關(guān)期刊論文 前10條

1 陳瑾華,宋清擰,陳正挺;周圍型類風濕性關(guān)節(jié)炎67例X線分析[J];福建醫(yī)藥雜志;2000年02期

2 柴維敏,陳克敏,顧越英,許建榮,丁小龍,李磊,姚秋英,王嵇,李增陽;磁共振成像在類風濕關(guān)節(jié)炎患者膝關(guān)節(jié)病變研究中的意義[J];中華風濕病學(xué)雜志;2002年05期

3 馬強,王峻;類風濕關(guān)節(jié)炎的核磁共振成像研究[J];中華風濕病學(xué)雜志;2003年01期

4 肖螢;張桂英;左小霞;羅卉;游運輝;;高分辨力超聲檢查在類風濕關(guān)節(jié)炎膝肘腕關(guān)節(jié)滑膜炎的應(yīng)用[J];中華風濕病學(xué)雜志;2006年02期

5 邱邐;羅燕;彭玉蘭;;類風濕性關(guān)節(jié)炎膝關(guān)節(jié)病變的超聲研究[J];四川大學(xué)學(xué)報(醫(yī)學(xué)版);2006年06期

6 李拾林;呂國榮;肖進益;林玲;李鴻江;;超聲在類風濕關(guān)節(jié)炎腕關(guān)節(jié)病變中的初步應(yīng)用[J];江西醫(yī)學(xué)院學(xué)報;2006年02期

7 董曼娟,倪立清,沈杰;類風濕性關(guān)節(jié)炎心臟損害的臨床分析[J];臨床心血管病雜志;2001年03期

8 李家增 ,陳超 ,王瑞;50例類風濕性關(guān)節(jié)炎早期X線表現(xiàn)[J];中原醫(yī)刊;2003年15期

9 郭艷華;宓士軍;宋晴;;超聲早期診斷類風濕性關(guān)節(jié)炎的臨床應(yīng)用研究[J];河北醫(yī)藥;2013年01期

10 彭梅;張學(xué)珍;尹正銀;李志軍;陳琳潔;;高頻超聲在膝關(guān)節(jié)積液診斷中的應(yīng)用[J];實用全科醫(yī)學(xué);2007年02期

本文編號：1897971