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find Keyword "关节炎" 390 results
  • 膝、腕关节滑膜超声在类风湿关节炎中的临床价值比较

    摘要:目的:探讨类风湿性关节炎(RA)病人膝、腕关节滑膜关节滑膜的超声检查指标与RA临床指标的相关性。方法:通过高频超声及彩色多普勒超声对RA病人(50 例)的膝、腕关节的滑膜情况(包括滑膜厚度、关节积液程度、滑膜彩色血流分级)进行观察,并获取RA患者疾病活动度(DAS28)分值、炎症指标C反应蛋白(CRP)、红细胞沉降率(ESR)、标记性抗体抗瓜氨酸抗体(CCP)和类风湿因子(RF)滴度水平并对上述指标做相关分析。结果:①RA病人膝关节滑膜厚度、关节积液程度、滑膜血流信号分级等级与患者DAS28(r=0.35、r=0.38、rs =0.54,Plt;0.05)、CRP(r=0.41、r=0.45、rs =0.57,Plt;0.05)、ESR(r=0.38、r=0.42、rs=0.51,Plt;0.05)均呈正相关;腕关节滑膜厚度、滑膜血流等级信号与患者DAS28(r=0.55、rs=0.69,Plt;0.05)、CRP(r=0.53、rs =0.67,Plt;0.05)、ESR(r=0.48、rs=061,Plt;0.05)均呈正相关,且相关系数高于膝关节组;②膝关节组滑膜厚度与关节积液程度、滑膜血流分级等级均呈正相关(Plt;0.05),关节积液程度与滑膜血流分级呈正相关(Plt;0.05);腕关节组滑膜厚度与滑膜血流分级等级均呈正相关(Plt;0.05);③膝、腕关节之间仅滑膜血流信号等级成等级正相关(Plt;0.05)。结论:膝、腕关节滑膜超声能较好地观察类风湿性关节炎病人滑膜的病变,其指标能作为一种客观有效的评价疗效、判断疾病活跃性及评估预后的指标,尤其应该以腕关节作为RA病人的优选关节。

    Release date:2016-09-08 10:12 Export PDF Favorites Scan
  • EXPERIMENTAL STUDY ON CD105+/CD166+ CELLS AND ITS CHONDROGENIC POTENTIAL IN EARLY OSTEOARTHRITIS CARTILAGE

    Objective To study the variation of CD105+/CD166+ cells and its multilineage potential in early osteoarthritis (OA) cartilage so as to lay a foundation for cartilage repair and pathologic cartilage remodeling in arthritis. Methods The knee OA model was established in the right knee of 30 adult New Zealand rabbits (8-12 months old). The chondrocytes were harvested from normal cartilage of the left knee (group A), OA cartilage of the right knee at 2 weeks (group B), at 4 weeks (group C), and at 8 weeks (group D) after modeling, and BMSCs were used in group E for the expression of CD105 and CD166. The percentage of CD105+/CD166+ cells in each group was counted by flow cytometry, and CD105+/CD166+ cells were isolated and purified by magnetic-activated cell sorting. The expressions of CD105 and CD166 were observed in 5 groups by laser scanning confocal microscope. Chondrogenesis, osteogenesis, and adipogenesis were evaluated with Alcian blue cytochemistry and collagen type II immunohistochemistry, by detecting the deposition of calcium, and with oil red O staining, respectively. Results The percentage of CD105+/CD166+ cells in group A, B, C, and D was significantly lower than that in group E (P lt; 0.05); it was significantly higher in groups B, C, and D than in group A (P lt; 0.05), and in group D than in groups B and C (P lt; 0.05), but no significant difference was found between groups B and C (P gt; 0.05). Laser scanning confocal microscope results confirmed the expressions of CD105+ and CD166+ cells in groups A, B, C, D, and E, no obvious difference in expression was shown among 5 groups. At 1 week after chondrogenic induction, positive expressions of proteoglycan and collagen type II were observed in 5 groups, no obvious difference was noticed among 5 groups. At 2 weeks after osteogenic induction, calcium level in group E was significantly higher than that in groups A, B, C, and D (P lt; 0.05), but no significant different was found among groups A, B, C, and D (P gt; 0.05). At 4 weeks after adipogenic induction, there were more red lipid droplets in group E than in groups A, B, C, and D. Conclusion CD105+/CD166+ cells in early OA cartilage increase, which show chondrogenic differentiation potential.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • OUTCOMES OF CEMENTLESS TOTAL HIP REPLACEMENT IN TREATMENT OF OSTEOARTHRITIS

    Objective To evaluate the clinical results of cementless total hip replacement (THR) in treating osteoarthritis and identifying the factors affecting the results. Methods From January 1995 to December 1999, 76 patients(85 hips) with osteoarthritis of hip joint were treated. These patients were assessed according to Harris hip score and X-ray film. The average follow-up time was 49.3 months. Results The average Harris score in the patients was 90.9 points. The excellent or good rate was 91.9%(75/85). Pain in the thigh existed in 23 hips (27.5%). The femoral osteolysis occurred in 14 hips(16.5%). The radiographical result demonstrated femoral loosening in 2 hips. harris score became lower when the femoral component of osteoarthritis of hip jointl. Pain in the thigh may be related to the varus placement of femoral component and femoral osteolysis. Femorla osteolysis is one of important factors affectin the long-term outcomes.

    Release date:2016-09-01 09:35 Export PDF Favorites Scan
  • Short-term Effect of Arthroscopic Microfracture Surgery Combined with Oral Glucosamine Hydrochloride in the Treatment of Early Knee Osteoarthritis

    ObjectiveTo investigate the clinical effect of arthroscopic microfracture surgery combined with oral glucosamine hydrochloride in the treatment of early knee osteoarthritis. MethodsWe retrospectively analyzed the clinical data of 172 patients with knee osteoarthritis treated between March 2007 and August 2013. The patients were divided into observation group (n=82) and control group (n=90) according to their treatment. Patients in the control group only underwent arthroscopic debridement and cartilage defect microfracture surgery, while those in the observation group underwent arthroscopic microfracture surgery combined with oral glucosamine hydrochloride. The Lysholm knee functional scores, the Lequesne index and X ray image were used to compare the clinical efficacy between the two groups. ResultsThe postoperative symptoms of both the two groups were significantly alleviated. The Lequesne index was not significantly different between the two groups before surgery, and 1 and 3 months after surgery (P>0.05), but it was significantly difference between the two groups 6, 12, 18 and 24 months after surgery (P<0.05). Before surgery, the Lysholm score was not significantly different between the two groups (P>0.05), and the score increased significantly after surgery in both the two groups (P<0.05). One and 3 months after surgery, the Lysholm score was not significantly different between the two groups (P>0.05), but it was significantly higher in the observation group 6, 12, 18 and 24 months after surgery. ConclusionArthroscopic microfracture surgery combined with oral glucosamine hydrochloride is effective in treating patients with early knee osteoarthritis, and the clinical efficacy becomes more significant with the time of treatment.

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  • RESEARCH PROGRESS OF VISCOSUPPLEMENTATION

    Objective To carry out a comprehensive and objective evaluation of viscosupplementation, so as to provide the actual judgments of effectiveness, development trends, and direction. Methods The related l iterature was reviewed, and the keys were the assessments from the international relevant advisory bodies and insurance companies and the evidence-based medicine on cl inic. Results Viscosupplementation has been gradually accepted. Although there are many different cl inical views of the viscosupplementation in the molecular weight of hyaluronan, injection dose, and the indications, intra-articular injection of hyaluronan for the treatment of osteoarthritis is well accepted. ConclusionViscosupplementation is one of the methods of treating osteoarthritis. As it has been already verified that hyaluronan iseffective in treating osteoarthritis of the knee and the periarthritis of shoulder, the hip joint injection is gradually recognized,and other small joints are going gradually.

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • 2008年8月14日Efficacy of Topical NSAIDs in the Treatment of Osteoarthritis:A Meta-analysis of Randomized Controlled Trials

    Objective To assess the efficacy of topical non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of osteoarthritis (OA). Methods MEDLINE, EMBASE, Scientific Citation Index, CINAHL, The Cochrane Library, CBMdisc and abstracts from conference were searched from 1966 to March 30, 2005. Randomized controlled trials (R.CT) comparing topical non-steroidal anti-inflammatory drug (NSAIDs) with placebo or oral NSAIDs in OA were induded. Effect size (ES) was calculated for pain, function and stiffness. Relative risk (RR) was calculated for dichotomous data such as clinical response rate and adverse effect rate. Number needed to treat to obtain the clinical response was estimated. The quality of trials was assessed and sensitivity analyses were undertaken. Results Topical NSAIDs were superior to placebo in relieving pain due to osteoarthritis only in the first 2 weeks of treatment; ES (95% CI) were 0.41 (0. 16 to 0.66) and 0.40 (0.15 to 0.65) at week 1 and 2 respectively. However, the effects were short-lived and no benefit was observed over placebo at the third and fourth week. A similar pattern was observed with function, stiflhess and clinical response RR and number needed to treat. Topical NSAIDs were inferior to oral NSAIDs at week 1, and associated with more local side effects such as rash, itch or burning (RR 5.29, 95% CI 1.14 to 24. 51 ). Conclusions Only very shortterm (less than 4 weeks) RCTs have assessed topical NSAID efficacy in OA ; after 2 weeks no efficacy above placebo has been obsevrved. There are no trial data to support the long-term use of topical NSAIDs in osteoarthritis.

    Release date:2016-09-07 02:26 Export PDF Favorites Scan
  • Observation on the Effect of Glucosamine Hydrochloride Combined with Antiosteoporosis Drugs in the Treatment of Senile Knee Osteoarthritis

    ObjectiveTo observe the clinical effect of combined glucosamine hydrochloride and antiosteoporosis drugs in the treatment of senile knee osteoarthritis. MethodsA total of 120 patients with osteoarthritis of the knee treated from January 2014 to December 2015 were randomly divided into observation group and control group with 60 cases in each. The observation group received not only oral glucosamine hydrochloride, but calcium D3, alfacalcidol, and sodium phosphate for anti-osteoporosis treatment, while the control group was only given oral glucosamine hydrochloride. Lequesne score, curative effect and adverse drug reactions were compared between the two groups 2, 4, and 6 weeks after the beginning of treatment. ResultsWithin two weeks of treatment, there was no significant difference between the two groups in the effective rate (P > 0.05) . But four and six weeks after treatment, the efficiency in the observation group was significantly higher than that in the control group (χ2=6.806, P < 0.01; χ2=24.762, P < 0.01) . Four and six weeks after treatment, Lequesne score of the observation group was significantly lower than that of the control group (t=2.199, P < 0.05; t=4.748, P < 0.001) . There was no significant difference in terms of adverse reactions between the two groups before and after treatment (χ2=0.617, P > 0.05) . ConclusionCompared with single hydrochloric amino glucose treatment, glucosamine hydrochloride combined with anti-osteoporosis treatment for senile knee osteoarthritis has better treatment effect without increase in adverse drug reactions, and it is worth of clinical application.

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  • AN EXPERIMENTAL STUDY ON EFFECT OF ESTROGEN ON OSTEOARTHRITIS IN FEMALE RATS

    Objective To investigate the effect ofestrogen on osteoarthritis in female rats.Methods Forty female rats were divided into four groups. In group Ⅰ, the rats were not given any treatment as a control. Ingroups Ⅱ, Ⅲ and Ⅳ, the rats received fixing left knee joint on extension position. Meanwhile, therats received ovariectomy in group Ⅲ; ovariectomy and diethylstilbestrol treatment in group Ⅳ, respectively. After 4 weeks, histological observation and serum BGP examination were done.Results In groups Ⅱ, Ⅲ andⅣ, the levels of serum BGP were 3.50±0.39, 5.72±0.64 and 3.95±0.44, respectively. The pathologic grades of cartilage and synovium were 10.83±4.35 and 4.21±2.03; 15.32±3.42 and 7.62±3.42; and 12.65±2.73 and 5.46±1.23, respectively. Conclusion Estrogen may play an important role in delaying the development of osteoarthritis.

    Release date:2016-09-01 09:35 Export PDF Favorites Scan
  • 双磷酸盐联合甲氨喋呤治疗绝经后类风湿关节炎患者疗效观察

    目的:评价双磷酸盐联合甲氨喋呤治疗绝经后类风湿关节炎患者疗效,分析治疗方法对类风湿关节炎活动度指标的影响。方法:选择2005~2007年我院住院及门诊的活动期类风湿关节炎患者75例,随机双盲分为2组,其中甲氨喋呤组45例,甲氨喋呤+双磷酸盐组30例。检测两组使用药物前后患者疾病活动性指标及血清中类风湿关节炎活动度相关指标,评价甲氨喋呤+双磷酸盐治疗方法的疗效。结果:甲氨喋呤+双磷酸盐治疗组可以提高骨密度,治疗后两组观察指标比较,甲氨喋呤+双磷酸盐组疾病活动度指标改善明显好于单用甲氨喋呤组。结论:双磷酸盐能有效防止骨丢失,帮助类风湿关节炎病情缓解。

    Release date:2016-09-08 10:02 Export PDF Favorites Scan
  • Observation on the Clinical Effect of Glucosamine in the Treatment of Patients with Knee Articular Cartilage Injury Caused by Rheumatoid Arthritis

    ObjectiveTo observe and study the clinical effect of glucosamine in the treatment of patients with knee articular cartilage injury caused by rheumatoid arthritis. MethodsForty-six patients with knee articular cartilage injury caused by rheumatoid arthritis treated from January 2013 to June 2015 were selected as the research subjects, and they were randomly divided into control group (conventional treatment group, n=23) and observation group (conventional and glucosamine treatment group, n=23) . Then the Noyes classification and serum articular cartilage injury related indexes [cartilage oligomeric matrix protein (COMP), matrix metalloproteinase (MMP)-1, MMP-3 and mouse tissue inhibitors of metalloproteinase (TIMP)-1], inflammatory indexes [tumor necrosis factor (TNF)-α, interleukin (IL)- 17 and IL-33] of the two groups before and after treatment were compared. ResultsIn the observation group, after treatment for 4, 8 and 12 weeks, Noyes grade was better than that in the control group, but with no statistical significance (P > 0.05) . In the observation group, after treatment for 4, 8 and 12 weeks, serum inflammatory markers serum COMP, MMP-1, MMP-3 and TIMP-1 and other related indicators of cartilage damage and serum TNF-α, IL-17 and IL-33 were all significantly lower than those in the control group (P < 0.05) . ConclusionIn the treatment of patients with knee articular cartilage injury caused by rheumatoid arthritis, glucosamine has active role for the improvement of articular cartilage injury and inflammatory stress state of patients.

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