课件：病例模板-益赛优秀病例交流.pptx

鼎例验证 共享得益---益赛普优秀病例交流益赛普优秀病例交流病例名称：益赛普治疗风湿性多肌痛医生姓名：陈俞池医院/科室：四川省中医院/风湿免疫科病情简介姓名（缩写）：刘××性别、年龄：女、61岁现病史：家族史/既往史：相关病情介绍：（可分为若干张幻灯，尤其是病例值得分享的地方）辅助检查检查项目结果影像学资料或照片（请于此处填写）诊断及诊断依据（请于此处填写）治疗经过及转归药物名称、剂量、方法安全性评价及处理（请于此处填写）随访及结局（请于此处填写）结合相关指南和文献的思考（请于此处填写）2007年意大利进行一项开放性试点研究：依那西普对难治性风湿性多肌痛的治疗纳入标准：复发性PMR 激素治疗至少持续12个月 存在类固醇激素相关不良事件 强的松的剂量不能低于7.5mg/天排除标准： 1、临床或病理学显示有巨细胞动脉炎 2、符合1987美国风湿病学会制定的RA 标准 3、存在难治性的糖尿病、高血压、感 染及肿瘤（包括多发性骨髓瘤）、肺 结核。治疗方案 1、患者接受48次依那西普注射治疗，25mg/次，2次/周，共24周，共随访9个月。 2、强的松减量方案： 7.5mg5mg完全缓解：2.5mg不完全缓解：5mg第24周完全缓解：撤离不完全缓解：2.5mg第4周第12周`Clinical and demographic characteristics of the patientsPatientAge,yearsSexPeripheral involvementDiseaseduration,monthsNumber ofrelapsesCorticosteroid-related adverseevents178M-954Osteoporotic fractures, cataract281F-403Diabetes, hypertension372F-573Diabetes, osteoporotic fractures463F-363Osteoporotic fractures576F-242Hypertension, diabetes680FHand extremity swellingwith pitting edema182Osteoporotic fractures, hypertensionClinical and laboratory course during the 6-month etanercept treatmentPatientTime 06 monthsESR,mm/hourCRP,mg/dlLeeb’s DAS(26)PDN dailydoseESR,mm/hourCRP,mg/dlLeeb’s DAS(26)PDN dailydoseAdverse events1230.1028.110230.163.662.5Flu2130.9022.27.5210.334.502.53350.1030.710260.523.4204111.8733.67.550.305.302.55130.5424.610120.193.512.5Bacterial cystitis6321.5619.77.5352.5610.312.5Bacterial cystitis All 6 patients were able to reduce their daily prednisone doses without relapses. One patient stopped prednisone at the end of etanercept treatment. Five patients had a Leeb’s DAS score 7 at the end of the treatment period, indicating low disease activity.Ultrasound shoulder examination during the 6-month etanercept treatmentPatientTime 06 monthsSubacromial bursa,right/leftLong biceps tendonsheath, right/leftGlenohumeraljoint, right/leftSubacromial bursa,right/leftLong biceps tendonsheath, right/leftGlenohumeraljoint, right/left1++/+-/+-/--/--/--/-2+++/+++/++-/-+/++/+-/-3++/+++/-+/++/+-/-+/+4++/-++/++-/--/--/+-/-5+/++-/++-/--/--