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首页> 外文期刊>Rheumatology >Triamcinolone acetonide and hexacetonide intra-articular treatment of symmetrical joints in juvenile idiopathic arthritis: a double-blind trial.
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Triamcinolone acetonide and hexacetonide intra-articular treatment of symmetrical joints in juvenile idiopathic arthritis: a double-blind trial.

机译：曲安奈德和己烯酮关节内治疗少年特发性关节炎的对称关节：一项双盲试验。

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OBJECTIVE: Pharmacokinetic studies have shown that the biological effect of triamcinolone acetonide (TA) is equivalent to that of triamcinolone hexacetonide (TH), if used at double the dosage. In this study we compared the efficacy of intra-articular TA at a dose twice that of TH in symmetrically involved joints, in children with juvenile idiopathic arthritis (JIA). METHOD: Children with active arthritis and a similar degree of inflammation in two symmetrical joints were enrolled in the study. The symmetry was assessed by both clinical examination and synovial fluid analysis. The dose given was 1 mg/kg up to 40 mg of TH or 2.0 mg/kg up to 80 mg of TA. The identity of injected compound was blinded to the patient and to the physician. RESULTS: Thirty-seven patients, 30 female, seven male, with JIA, entered the study. A total of 86 joints were injected. Twenty-one (53.8%) of the joints injected with TA relapsed first compared with only six (15.4%) of the joints injected with TH. In three (7.7%) relapse occurred simultaneously. Nine (23%) were still in remission after 24-month follow-up. The percentage of joints with lasting remission was higher with TH than with TA (80 vs 47.5% after 12 months and 63.6 vs 32.4% after 24 months, respectively; log rank test P = 0.003). CONCLUSION: Even when TA is given at higher doses, TH is more effective and should be considered the drug of choice for intra-articular treatment of JIA.
机译：目的：药代动力学研究表明，如果以两倍的剂量使用曲安奈德（TA），其生物学效果与曲安奈德（TH）相同。在这项研究中，我们比较了幼年特发性关节炎（JIA）患儿关节内TA的剂量（其剂量是TH的两倍）在对称受累关节中的功效。方法：本研究纳入了患有活动性关节炎且两个对称关节的炎症程度相似的儿童。通过临床检查和滑液分析评估对称性。给定的剂量为1 mg / kg（最高40 mg TH）或2.0 mg / kg（最高80 mg TA）。注射的化合物的身份对患者和医生都是未知的。结果：37例JIA患者，其中女性30例，男性7例。总共注射了86个关节。注射TA的关节中二十一（53.8％）首先复发，而注射TH的关节中只有六个（15.4％）复发。在三例（7.7％）中同时发生复发。 24个月的随访后，仍有9例（23％）缓解。 TH可使关节持续缓解的百分比高于TA（12个月后为80 vs 47.5％，24个月后为63.6 vs 32.4％;对数秩检验P = 0.003）。结论：即使以更高剂量给予TA，TH仍更有效，应被视为关节内治疗JIA的首选药物。

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