生物制剂治疗的类风湿关节炎患者关节镜下滑膜切除术后康复的长期疗效

Long-Term Efficacy of Rehabilitation Following Arthroscopic Synovectomy in Patients With Rheumatoid Arthritis Treated With Biologic Agents.

作者信息

Kanbe Katsuaki, Sekine Chiaki

机构信息

Department of Rehabilitation, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan.

Department of Orthopaedic Surgery, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan.

出版信息

Ann Rehabil Med. 2017 Dec;41(6):998-1004. doi: 10.5535/arm.2017.41.6.998. Epub 2017 Dec 28.

DOI:10.5535/arm.2017.41.6.998

PMID:29354576

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5773443/

Abstract

OBJECTIVE

To investigate the long-term efficacy of rehabilitation following arthroscopic synovectomy in patients with rheumatoid arthritis treated with biologic agents.

METHODS

Arthroscopic synovectomy was performed in 29 joints of 17 patients, which were divided into two groups. Group 1 included arthroscopic synovectomy plus rehabilitation for 19 joints in 10 patients, and group 2 included arthroscopic synovectomy without rehabilitation for 10 joints in 7 patients. The Disease Activity Score C-reactive protein (DAS28-CRP), Health Assessment Questionnaire-Disability Index (HAQ-DI), and Functional Independence Measure (FIM) values (motor subscale) at 9.7 years after arthroscopic synovectomy were evaluated to identify the clinical factors related to outcomes.

RESULTS

The increase in FIM score was significant in group 1 (p=0.05). HAQ-DI at 9 years was significantly decreased in group 1 (p=0.02). Therefore, arthroscopic synovectomy with rehabilitation was significant in improving FIM and HAQ-DI scores over a long period. Multiple regression analysis of FIM scores at 9 years indicated that rehabilitation (p=0.03) and disease duration (p=0.02) were significantly related to outcomes. FIM score at 9 years was significantly negatively correlated with disease duration (p=0.01, r=-0.58, Y=88.89-0.21X).

CONCLUSION

Rehabilitation following arthroscopic synovectomy was effective in achieving high FIM scores over time in patients with rheumatoid arthritis.

摘要

目的

探讨生物制剂治疗的类风湿关节炎患者关节镜下滑膜切除术后康复的长期疗效。

方法

对17例患者的29个关节进行关节镜下滑膜切除术，分为两组。第1组包括10例患者19个关节的关节镜下滑膜切除术加康复治疗，第2组包括7例患者10个关节的关节镜下滑膜切除术但无康复治疗。评估关节镜下滑膜切除术后9.7年时的疾病活动评分C反应蛋白（DAS28-CRP）、健康评估问卷残疾指数（HAQ-DI）和功能独立性测量（FIM）值（运动分量表），以确定与结局相关的临床因素。

结果

第1组FIM评分增加显著（p=0.05）。第1组9年时的HAQ-DI显著降低（p=0.02）。因此，关节镜下滑膜切除术联合康复治疗在长期改善FIM和HAQ-DI评分方面具有显著意义。对9年时FIM评分的多元回归分析表明，康复治疗（p=0.03）和病程（p=0.02）与结局显著相关。9年时FIM评分与病程显著负相关（p=0.01，r=-0.58，Y=88.89-0.21X）。