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膝关节骨关节炎患者关节内注射类固醇激素反应的预测因素。

Predictors of response to intra-articular steroid injections in patients with osteoarthritis of the knee joint.

作者信息

Fatimah Nibah, Salim Babur, Raja Ejaz-Ul-Haq, Nasim Amjad

机构信息

Foundation University Medical College, Rawalpindi, Pakistan.

Fauji Foundation Hospital, Jhelum road, Rawalpindi, 46000, Pakistan.

出版信息

Clin Rheumatol. 2016 Oct;35(10):2541-7. doi: 10.1007/s10067-016-3365-z. Epub 2016 Jul 30.

Abstract

This study aimed to determine the factors associated with response to intra-articular steroid injection (IASI) in patients with knee joint osteoarthritis. One hundred seventy-four female patients, age ranging from 30 to 80 years, diagnosed to have osteoarthritis of the knee joint, were given IASI. Response to IASI was assessed by using WOMAC and VAS at 2 weeks, 4 weeks and 3 months. At 3 months, the subjects were categorized as responders, partial responders and non-responders to treatment by IASI. Various factors were narrowed down to see their effect on response, namely age, BMI, smoking habits, comorbidities, presence of clinical effusion, radiographic score, local knee tenderness, range of movement and socioeconomic status. One hundred twenty-four patients completed the study. 16.1 % showed 50 % or more improvement in WOMAC score at 3 months post IASI therapy, whereas 38.7 % of OA patients had more than 50 % improvement in VAS score. Out of all factors, range of movement, local knee tenderness and radiographic score of the affected joint are the three parameters which can predict the improvement in WOMAC score after 3 months of IASI therapy (P = 0.013, P = 0.045 and P = 0.000, respectively). Age of the patient can predict improvement in VAS at 3 months post IASI (P = 0.027). We conclude that age, range of movement, local knee tenderness and radiographic score of the affected joint can predict response to IASI after 3 months of IASI therapy.

摘要

本研究旨在确定膝关节骨关节炎患者关节内注射类固醇(IASI)治疗反应的相关因素。174名年龄在30至80岁之间、被诊断为膝关节骨关节炎的女性患者接受了IASI治疗。在2周、4周和3个月时,使用WOMAC和VAS评估IASI治疗反应。在3个月时,将受试者分为对IASI治疗有反应者、部分反应者和无反应者。缩小各种因素范围以观察其对治疗反应的影响,即年龄、体重指数、吸烟习惯、合并症、临床积液情况、影像学评分、膝关节局部压痛、活动范围和社会经济状况。124名患者完成了研究。16.1%的患者在IASI治疗后3个月时WOMAC评分改善50%或更多,而38.7%的骨关节炎患者VAS评分改善超过50%。在所有因素中,活动范围、膝关节局部压痛和患侧关节影像学评分是可预测IASI治疗3个月后WOMAC评分改善情况的三个参数(P值分别为0.013、0.045和0.000)。患者年龄可预测IASI治疗后3个月时VAS评分的改善情况(P = 0.027)。我们得出结论,年龄、活动范围、膝关节局部压痛和患侧关节影像学评分可预测IASI治疗3个月后的治疗反应。

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