Howson M P, Shepard N L, Mitchell N S
Duke University Medical Center, Durham, North Carolina.
Clin Orthop Relat Res. 1988 Apr(229):283-93.
Radioisotopes have been employed in the therapy of chronic arthritis, in particular, rheumatoid arthritis for many years. A variety of isotopes have been popularized, and in the last ten years a colloidal solution of radioactive chromic phosphate 32P has been in use apparently with equivalent efficacy to others such as 169erbium, 90yttrium, and 165dysprosium. No controlled studies on this modality have been reported and few animal studies were found. The efficacy of therapeutic doses of 32P as a medical synovectomy and its effect on rabbit joints with antigen-induced arthritis were observed in 62 arthritic knee joints in 31 adult rabbits treated on one side with 0.1 microCi of 32P, the opposite serving as control. The animals were observed over a period of 11 months and examined by histologic and biochemical means. The synovium showed no evidence of radiation necrosis in treated joints. Cartilage of treated and control joints showed similar changes consistent with chronic arthritis, persistent synovitis, progressive chondrocyte degeneration, and decreased matrix metachromasia. The radiosynovectomy had neither removed synovium nor protected the cartilage. Its efficacy in humans is therefore questionable.
放射性同位素多年来一直用于慢性关节炎，尤其是类风湿性关节炎的治疗。多种同位素已得到推广，在过去十年中，放射性磷酸铬32P胶体溶液一直在使用，其疗效显然与其他同位素如169铒、90钇和165镝相当。尚未有关于这种治疗方式的对照研究报告，且仅发现少量动物研究。在31只成年兔的62个关节炎膝关节中，对一侧用0.1微居里32P治疗、另一侧作为对照的情况进行观察，以研究治疗剂量的32P作为药物滑膜切除术的疗效及其对抗原诱导性关节炎兔关节的影响。对这些动物进行了11个月的观察，并通过组织学和生化方法进行检查。在治疗的关节中，滑膜未显示出辐射坏死的迹象。治疗组和对照组关节的软骨显示出与慢性关节炎、持续性滑膜炎、进行性软骨细胞变性和基质异染性降低一致的相似变化。放射性滑膜切除术既未切除滑膜，也未保护软骨。因此，其在人体中的疗效值得怀疑。
