Bridges S L, López-Méndez A, Han K H, Tracy I C, Alarcón G S
Division of Clinical Immunology and Rheumatology, University of Alabama, Birmingham 35294.
J Rheumatol. 1991 Jul;18(7):984-8.
To determine if methotrexate (MTX) contributes to early postoperative complications, we studied 38 patients with rheumatoid arthritis (RA) who underwent elective orthopedic surgery. There were 4 complications of prosthetic joint infection or wound dehiscence or infection among 19 procedures performed on patients who continued MTX until less than 4 weeks before surgery, compared to no complications among 34 procedures performed on patients who discontinued MTX 4 weeks before surgery or who were taking no remittive agent for 3 months before surgery (p less than 0.03, Fisher's exact, 2-tailed). No demographic, clinical, laboratory, nutritional, or intraoperative differences between the 2 groups were apparent, suggesting that MTX may play a role in early postoperative complications in patients with RA. A larger, prospective trial to study this issue is warranted.
为了确定甲氨蝶呤（MTX）是否会导致术后早期并发症，我们研究了38例接受择期骨科手术的类风湿关节炎（RA）患者。在术前持续使用MTX直至术前不到4周的患者所进行的19例手术中，有4例发生了人工关节感染、伤口裂开或感染并发症，而在术前4周停用MTX或术前3个月未服用缓解药物的患者所进行的34例手术中则无并发症发生（p<0.03，Fisher精确检验，双侧）。两组之间在人口统计学、临床、实验室、营养或术中方面均无明显差异，这表明MTX可能在RA患者术后早期并发症中起作用。有必要进行一项更大规模的前瞻性试验来研究这个问题。
