Werlen D, Gabay C, Vischer T L
Rheumatology Department, Cantonal University Hospital, Geneva, Switzerland.
Rev Rhum Engl Ed. 1996 Apr;63(4):248-54.
To evaluate glucocorticoids as an alternative to nonsteroidal antiinflammatory drugs in patients with crystal-induced arthritis, a study was conducted in 27 patients with acute attacks of gout or chondrocalcinosis. Patients with contraindications to nonsteroidal antiinflammatory drug therapy were given either a single intramuscular injection of 7 mg betamethasone (group B, n = 10) or, if they were receiving anticoagulant therapy, a single intravenous injection of 125 mg methylprednisolone (group C, n = 7). The remaining patients (group A, n = 10) were given diclofenac in a dosage of 150 mg per day for three days then 75 mg per day for three days. Efficacy was evaluated based on the self-evaluated subjective improvement (%) and on the severity of joint swelling on days 1, 3, and 6. Both parameters improved promptly in all three groups. C-reactive protein decreased between baseline and day 6. Few patients had relapses. Glucocorticoid therapy was well tolerated. Our data show that a single intramuscular or intravenous injection of a glucocorticoid is safe and effective in patients with crystal-induced arthritis and risk factors for intolerance to nonsteroidal antiinflammatory drugs.
为了评估糖皮质激素在晶体诱导性关节炎患者中作为非甾体抗炎药替代品的效果，对27例痛风或软骨钙质沉着症急性发作患者进行了一项研究。对非甾体抗炎药治疗有禁忌证的患者，要么单次肌内注射7 mg倍他米松（B组，n = 10），要么如果他们正在接受抗凝治疗，则单次静脉注射125 mg甲泼尼龙（C组，n = 7）。其余患者（A组，n = 10）给予双氯芬酸，剂量为每天150 mg，持续三天，然后每天75 mg，持续三天。根据自我评估的主观改善情况（%）以及第1、3和6天关节肿胀的严重程度评估疗效。所有三组的这两个参数均迅速改善。C反应蛋白在基线和第6天之间下降。很少有患者复发。糖皮质激素治疗耐受性良好。我们的数据表明，单次肌内或静脉注射糖皮质激素对晶体诱导性关节炎且有非甾体抗炎药不耐受风险因素的患者是安全有效的。
