[关节镜下类风湿性膝关节滑膜部分切除术1天后预后与滑膜组织学特征的关系]。

Ryumachi. [Rheumatism] Pub Date : 2003-06-01
Yoshitaka Toda
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引用次数: 0

摘要

44例类风湿性关节炎(RA)患者膝关节积液在关节术下行部分滑膜切除术,随后用3000 ml生理盐水冲洗关节。44例中有17例在手术后一年内再次出现水肿(复发组)。其余27例为不复发组。组织学特征与类风湿关节炎一致(表面细胞、栅栏状细胞、多核巨细胞、淋巴细胞、浆细胞、肉芽组织增生;以及纤维蛋白样坏死和铁蛋白沉积的发生)根据每个特征的严重程度进行分级,根据小泉的标准。未复发组重淋巴细胞及浆细胞浸润率显著高于复发组(P = 0.00、0.001)。因此,我们认为类风湿膝关节一日关节镜滑膜部分切除术的预后与滑膜的病理特征有关。
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[The relationship between prognosis after one-day arthroscopic partial synovectomy on rheumatoid knee joints and the histologic features of the synovial membrane].

Forty four rheumatoid arthritis (RA) patients with hydrops of the knee joint had partial synovectomy of the knee joint performed under arthrosopy and subsequent irrigation of the joint with 3,000 ml physiological salile solution. Seventeen out of these 44 cases demonstrated recurring hydrops at one year after the procedures (the recurrence group). The remaider (n = 27) was regarded as the non-recurrence group. The histological features consistent with RA (proliferation of surface cells, palisade fasion, multi-nucleated giant cells, lymphocytes, plasma cells and granulation tissue; and the occurrence of fibrinoid necrosis and ferritin depotits) were graded depending on the severity of each feature, according to Koizumi's criteria. The rate of heavy lymphocyte and plasma cell infiltration in the non-recurrence group was significantly higher than that in the recurrence group (P = 0.00 and 0.001, respectively). Therefore, we concluded that the prognosis for one-day arthroscopic partial synovectomy on rheumatoid knee joints is related to the pathological features of the synovial membrane.

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