Amini Azam, Yahyanezhad Shiva, Velez Erik, Gholamrezanezhad Ali, Fotoohi Morteza, Jafari Esmail, Assadi Majid
Department of Internal Medicine, Division of Rheumatology, School of Medicine.
Department of Molecular Imaging and Radionuclide Therapy (MIRT), The Persian Gulf Nuclear Medicine Research Center, Bushehr Medical University Hospital, Bushehr University of Medical Sciences Bushehr, Iran.
Nucl Med Commun. 2020 Jan;41(1):65-72. doi: 10.1097/MNM.0000000000001116.
To determine the efficacy of Phosphorus-32 radiation synovectomy in the treatment of patients with severe rheumatoid arthritis (RA) unresponsive to systematic or local medical therapy.
Twenty-three knees in 16 patients with severe chronic RA were prospectively treated by intra-articular installation of Phosphorus-32 and evaluated at 1, 3, 6, and 12 months. The Western Ontario and McMaster Universities Arthritis index (WOMAC), visual analog scale (VAS), Health Assessment Questionnaire (HAQ), pain scale, and grade of joint effusion and tenderness were assessed. At the 12-month time interval, the treated knees were classified into four categories: excellent response (no symptoms), good response (significant reduction of symptoms), moderate response (slight decrease), and poor response (no change or worsening).
Excellent response or good response was observed in 13/23 (56.5%) of the treated knees, moderate response in 2/23 (8.7%) of the treated knees, and poor response in 8/23 (34.8%) of the treated knees. The grades of effusion and tenderness were significantly decreased one-month posttreatment (P< 0.05); however, these changes did not persist at other time intervals (P > 0.05). There was a significant improvement in the HAQ, WOMAC, VAS, and pain scores at all time points compared with baseline, including at the 12-month time interval (P < 0.05).
Phosphorus-32 radiosynovectomy is an effective therapeutic treatment for patients with RA of the knee unresponsive to conventional pharmacotherapy.
确定磷-32放射性滑膜切除术治疗对全身或局部药物治疗无反应的重度类风湿关节炎（RA）患者的疗效。
对16例重度慢性RA患者的23个膝关节进行前瞻性治疗，通过关节腔内注入磷-32，并在1、3、6和12个月时进行评估。评估了西安大略和麦克马斯特大学关节炎指数（WOMAC）、视觉模拟量表（VAS）、健康评估问卷（HAQ）、疼痛量表以及关节积液和压痛等级。在12个月的时间间隔时，将接受治疗的膝关节分为四类：优秀反应（无症状）、良好反应（症状显著减轻）、中等反应（稍有减轻）和差反应（无变化或恶化）。
在接受治疗的23个膝关节中，13个（56.5%）出现优秀反应或良好反应，2个（8.7%）出现中等反应，8个（34.8%）出现差反应。治疗后1个月时，积液和压痛等级显著降低（P<0.05）；然而，这些变化在其他时间间隔未持续存在（P>0.05）。与基线相比，在所有时间点，包括12个月时间间隔时，HAQ、WOMAC、VAS和疼痛评分均有显著改善（P<0.05）。
磷-32放射性滑膜切除术是治疗对传统药物治疗无反应的膝关节RA患者的有效治疗方法。
