Department of Nuclear Medicine, GH Kassel, Mönchebergstr. 41-43, 34125 Kassel, Germany.
Rheumatol Int. 2012 Oct;32(10):3219-24. doi: 10.1007/s00296-011-2143-0. Epub 2011 Oct 1.
In this retrospective study, we evaluated the effect of radiosynovectomy of patients with rheumatoid arthritis. Radiosynovectomy was performed in 577 joints of 137 rheumatoid patients. We applied 185 MBq yttrium-90 in knees (n = 58), 74-111 MBq rhenium-186 colloids in ankle (n = 50), wrists (n = 43) and shoulders (n = 35), and 15 to 37 MBq in finger (n = 298) and toe joints (n = 46). The effect of radiosynovectomy was scored in 4 subjective categories: excellent response (no symptoms); good response (significant reduction of symptoms); moderate response (slight decrease); and bad response (no change or worsening), of pain and/or swelling in treated joint 3 months after the procedure. Excellent or good response was observed in 57% of treated knees, 63% of shoulders, 60% of wrists, 64% of ankles, 54% of thumb bases, 55% of MCP's, 54% of PIP's, 53% of DIP's, and 54% of MTP's. Side effects associated to the RSO, i.e., swelling or transient increase of pain, were recorded in 7% of the patients that resolved within 1 month. No patient had any non-reversible skin alteration after treatment, only slight erythema was observed in 5 patients. Radiosynovectomy is effective and safe in the treatment of rheumatoid arthritis.
在这项回顾性研究中，我们评估了放射性滑膜切除术对类风湿关节炎患者的疗效。放射性滑膜切除术在 137 例类风湿关节炎患者的 577 个关节中进行。我们在膝关节中应用了 185MBq 的钇-90（n=58）、踝关节中应用了 74-111MBq 的锝-186 胶体（n=50）、腕关节（n=43）和肩关节（n=35），以及手指（n=298）和脚趾关节（n=46）中应用了 15-37MBq。放射性滑膜切除术的疗效在 4 个主观类别中进行评分：优秀反应（无症状）；良好反应（症状明显减轻）；中度反应（轻度减少）；以及不良反应（无变化或恶化），即在手术后 3 个月内治疗关节的疼痛和/或肿胀。治疗后的膝关节中，57%的患者表现出优秀或良好的反应，63%的肩关节、60%的腕关节、64%的踝关节、54%的拇指基底部、55%的掌指关节、54%的近节指间关节、53%的远节指间关节和 54%的跖趾关节也表现出优秀或良好的反应。与 RSO 相关的副作用，即肿胀或疼痛短暂增加，在 7%的患者中被记录到，这些患者在 1 个月内得到缓解。治疗后没有患者出现不可逆转的皮肤改变，仅有 5 名患者出现轻微红斑。放射性滑膜切除术在类风湿关节炎的治疗中是有效且安全的。
