Shupak R, Teitel J, Garvey M B, Freedman J
St. Michael's Hospital, University of Toronto, Ontario, Canada.
Am J Hematol. 1988 Jan;27(1):26-9. doi: 10.1002/ajh.2830270107.
This small pilot study examined the use of intraarticular methylprednisolone in hemophilic synovitis. Nineteen joints in ten adult hemophiliacs were studied. There was subjective improvement at 24 hr following injection in 79% of joints injected, and the improvement persisted up to 8 wk in 58%. The number of hemarthroses decreased following intraarticular steroids (mean of 7.7 bleeds in the 8 wk prior to injection versus a mean of 1.9 bleeds in the 8 wk following injection). Similarly the amount of clotting factor used for the injected target joint decreased from a mean of 7,616 units to 2,315 units postinjection (p less than .001). Improvement correlated with presence of synovitis but not with radiologic stage of the joint. Aspirated synovial fluids were analyzed and showed characteristics consistent with low-grade inflammation. These preliminary observations suggest that intraarticular corticosteroid injection may be a useful therapeutic tool in the medical management of hemophilic arthropathy.
这项小型试点研究考察了关节腔内注射甲基强的松龙在血友病性滑膜炎中的应用。对10名成年血友病患者的19个关节进行了研究。79%接受注射的关节在注射后24小时出现主观改善，58%的改善持续长达8周。关节腔内注射类固醇后关节积血次数减少（注射前8周平均出血7.7次，注射后8周平均出血1.9次）。同样，用于注射目标关节的凝血因子量从注射前的平均7616单位降至注射后的2315单位（p<0.001）。改善情况与滑膜炎的存在相关，但与关节的放射学分期无关。对抽取的滑液进行分析，结果显示其特征与低度炎症相符。这些初步观察结果表明，关节腔内注射皮质类固醇可能是血友病性关节病药物治疗中的一种有用的治疗手段。
