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西班牙首项关于超声引导下骶髂关节注射对脊柱关节炎患者有效性的研究。

First Spanish study on the effectiveness of ultrasound-guided sacroiliac joint injection in patients with spondyloarthritis.

作者信息

Ramírez Huaranga Marco A, Castro Corredor David, Plasencia Ezaine Angel E, Paulino Huertas Marco, Arenal Lopez Rocío, Fernández Joaquín Anino, Ramos Rodríguez Claudia C

机构信息

Interventional Rheumatology.

Rheumatology Department.

出版信息

Rheumatol Adv Pract. 2022 May 23;6(2):rkac036. doi: 10.1093/rap/rkac036. eCollection 2022.

Abstract

OBJECTIVE

The aim was to assess clinical improvement after US-guided injection of CSs into the SI joint of patients with SpA.

METHODS

This was an observational, descriptive, retrospective study of patients with SpA and sacroiliitis who received an US-guided injection into the SI joint between 1 June 2020 and 31 May 2021. Means were compared using Student's paired -test for the variables visual analog scale (VAS), BASDAI, ASDAS, CRP and ESR before and after the procedure. We evaluated the association between these variables and the clinical response using the odds ratio.

RESULTS

We analysed 32 patients with SpA [age 42.69 (8.19) years; female sex, 56.25%], with a VAS score of 7.88 (0.79), BASDAI of 5.43 (1.48) and ASDAS of 3.27 (0.86) before the procedure. At 2-3 months, 75% of patients had improved: VAS 3.81 (2.33) (-4.07,  < 0.0001) and BASDAI 3.24 (1.6) (-2.19,  < 0.0001). At 5-6 months, 59.37% had improved: VAS 4.63 (2.31) (-3.25,  < 0.0001), BASDAI 3.57 (1.67) (-1.86,  < 0.0001) and ASDAS 2.27 (0.71) (-1.0,  < 0.0001). Bone marrow oedema resolved in 87.5% of cases compared with the previous MRI scan. No significant association was identified with the clinical response to the injection.

CONCLUSION

US-guided injection of CSs into the SI joint of patients with SpA and active sacroiliitis leads to an improvement in symptoms that is maintained at 5-6 months. The procedure is effective, safe, inexpensive and easy to apply.

摘要

目的

评估超声引导下向脊柱关节炎(SpA)患者的骶髂关节注射皮质类固醇(CSs)后的临床改善情况。

方法

这是一项对2020年6月1日至2021年5月31日期间接受超声引导下骶髂关节注射的SpA和骶髂关节炎患者进行的观察性、描述性、回顾性研究。使用学生配对t检验比较手术前后视觉模拟量表(VAS)、巴斯强直性脊柱炎疾病活动指数(BASDAI)、强直性脊柱炎疾病活动评分(ASDAS)、C反应蛋白(CRP)和红细胞沉降率(ESR)等变量的均值。我们使用优势比评估这些变量与临床反应之间的关联。

结果

我们分析了32例SpA患者[年龄42.69(8.19)岁;女性占56.25%],手术前VAS评分为7.88(0.79),BASDAI为5.43(1.48),ASDAS为3.27(0.86)。在2至3个月时,75%的患者症状改善:VAS为3.81(2.33)(-4.07,<0.0001),BASDAI为3.24(1.6)(-2.19,<0.0001)。在5至6个月时,59.37%的患者症状改善:VAS为4.63(2.31)(-3.25,<0.0001),BASDAI为3.57(1.67)(-1.86,<0.0001),ASDAS为2.27(0.71)(-1.0,<0.0001)。与之前的磁共振成像(MRI)扫描相比,87.5%的病例骨髓水肿消退。未发现与注射的临床反应有显著关联。

结论

超声引导下向SpA和活动性骶髂关节炎患者的骶髂关节注射CSs可使症状改善,并在5至6个月时维持。该手术有效、安全、廉价且易于实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed30/9154057/04d0b28a2138/rkac036f1.jpg

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