Wang Z, Zhang Y, Ge Y H, Liu H J, Liu Y H, Zhao J J, Dou Y C, Lei P C
Department of Hematology, Henan Province People's Hospital, Zhengzhou 450003, China.
Zhonghua Xue Ye Xue Za Zhi. 2017 Jan 14;38(1):39-43. doi: 10.3760/cma.j.issn.0253-2727.2017.01.009.
To observe the therapeutic response of radiosynovectomy with p-32 colloid on hemophilic arthropathy, and to assess the effects of radiosynovectomy with Denver Score on hemophilic arthritis staging. Radiosynovectomy with p-32 colloid was performed on 326 hemophilic arthritis patients (405 joints) , and recorded bleeding before and after treatment. The MRI performance of 102 joints was evaluated by using Denver scoring system, then was divided into 0-6 and 7-10 groups. Finally, the differences between 2 groups were analyzed. Average pain score of all hemophilic arthritis patients at 6 months, 1, 2 and 3 years post treatment decreased from 3.2±2.4 (=326) to 1.2±0.6 (=285, =0.021) , 1.7±0.5 (=242, =0.032) , 2.1±1.1 (=212, =0.030) and 2.2±1.6 (=176, =0.037) , respectively. The frequency of bleeding in 405 joints at 1, 2 and 3 years post treatment decreased from 15.1±3.6 to 2.1±0.7, 4.3±0.6, and 4.8±0.8 times per year (<0.01) , respectively; Meanwhile, the proportions of significantly ameliorated joints' activities were observed as of 68.50% (248/362) , 58.39% (181/310) , 55.67% (162/239) and 42.61% (75/176) , respectively. The frequencies of haemarthrosis at 1 and 2 years post treatment in patients with 0-6 Denver Score (45 target joints) reduced from 13.0±1.9 to 1.3±0.6 (=0.002) and 3.1±0.9 (=0.009) times per year, respectively, which also decreased in 7-10 group (57 target joints) from 16.6±2.1 to 3.1±0.9 (=0.008) and 5.7±1.1 (=0.004) times per year, respectively. There was no statistical difference between 0-6 and 7-10 groups before treatment in the terms of haemarthrosis frequency (=0.773) . However, 7-10 group had higher haemarthrosis frequency at 1 and 2 years post treatment compare with 0-6 group (=0.028 and 0.042, respectively) . Synovial volumes in 29 joints reduced after 6 month when compared with baseline [ (2 362.15±32.41) mm(3) (3 012.40±39.78) mm(3), =7.621, <0.001]. Radiosynovectomy with p-32 colloid on haemophilic synovitis was a safe and effective procedure. The patients with Denver Score of 0-7 had lower frequency of haemarthrosis.
观察32P胶体放射性滑膜切除治疗血友病性关节病的疗效，以及丹佛评分对血友病性关节炎分期的评估作用。对326例血友病性关节炎患者（405个关节）行32P胶体放射性滑膜切除术，记录治疗前后的出血情况。采用丹佛评分系统评估102个关节的MRI表现，分为0 - 6组和7 - 10组，最后分析两组间的差异。所有血友病性关节炎患者治疗后6个月、1年、2年和3年的平均疼痛评分分别从3.2±2.4（n = 326）降至1.2±0.6（n = 285，P = 0.021）、1.7±0.5（n = 242，P = 0.032）、2.1±1.1（n = 212，P = 0.030）和2.2±1.6（n = 176，P = 0.037）。405个关节治疗后1年、2年和3年的出血频率分别从15.1±3.6降至2.1±0.7、4.3±0.6和4.8±0.8次/年（P < 0.01）；同时，关节活动明显改善的比例分别为68.50%（248/362）、58.39%（181/310）、55.67%（162/239）和42.61%（75/176）。丹佛评分为0 - 6分（45个靶关节）的患者治疗后1年和2年的关节积血频率分别从13.0±1.9降至1.3±0.6（P = 0.002）和3.1±0.9（P = 0.009）次/年，丹佛评分为7 - 10分（57个靶关节）的患者分别从16.6±2.1降至3.1±0.9（P = 0.008）和5.7±1.1（P = 0.004）次/年。治疗前，0 - 6组和7 - 10组的关节积血频率差异无统计学意义（P = 0.773）。然而，治疗后1年和2年，7 - 10组的关节积血频率高于0 - 6组（分别为P = 0.028和0.042）。29个关节治疗6个月后的滑膜体积较基线缩小[（2 362.15±32.41）mm³对（3 012.40±39.78）mm³，P = 7.621，P < 0.001]。32P胶体放射性滑膜切除治疗血友病性滑膜炎是一种安全有效的方法。丹佛评分为0 - 7分的患者关节积血频率较低。
