骨关节炎及其药物治疗的最佳选择

,,(osteoarthritis,OA)15%,43%OA,65,OA,751OAOA54555,,55OA,OAOAOAOA,OAOA,OA,30%,,,,,,,OA,OAOA,,,,,,,:100853,,,,OA,,,OA(RA),OA,,RA,COAXOAOA90,OA,OA,,OA,OA,OA1:OA,(),,,3g/d,,():,OA,,OA,,;9212003373ChinJRheumatol,March2003,Vol7,No.3©1994-2008ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.[1],[2],2200,OA,,OA:OA,,;,4g214g,,68,19d,13[3],,2:OA,,OA1969(glucosaminesulfate,GS)OA,20,GSOA,,OAGSOA,,,,,,90%4hGS,,,,,,,GSOA,(),(IL)21,,GSGS,,,,OA2004,GS1500mg/d48%,1200mg/d52%(P=0167);()GS6%1%,35%7%(P01010105)GSOA,GSOA212OA3,X,,0131mm,GS1500mg/d(Rotta,),0106mm,[4]202OA,3,X0119mm,GS1500mg/d(Rotta)(P=01001)[5],GSOA,GSOAOA,GS,0312003373ChinJRheumatol,March2003,Vol7,No.3©1994-2008ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.(),OAGS,OA(diacerein,):,,IL21,,OA,OA,OA[6]404OA16,100mg/d,,[7],3OA,3ACDE,,OAACE,OADOA,3OA:OA,,,,AD,CCOA,,OA129OAE600mg/d,10d,,52%,4%OA4,OA,,,,,,,,OA,,OA:;;;E2,[(115215)106],2ml,1,,51,(Synvisc,6106),2ml,1,31,1590RA,,OA,,OA,,,,,GS,,1AltmanRD,HochbergMC,MoskowitzKW,etal.RecommendationsfortheMedicalmanagementofosteoarthritisofthehipandknee.2000up2date.AmericanCollegeofRheumatologySubcommitteeonOsteoarthritisGuidelines.ArthritisRheum,2000,43:19052191512AhmadSR,KortepeterC,BrinkerA,etal.Renalfailureassociatedwiththeuseofcelecoxibandrofecoxib.DrugSafety,2002,25:537254413PelosoPM.Opioidtherapyforosteoarthritisofthehipandknee:useitforloseit?JRheumatol,2001,28:621114ReginsterJY,DeroisyR,RovatiLC,etal.Long2termeffectsofglu21312003373ChinJRheumatol,March2003,Vol7,No.3©1994-2008ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.:251225615PavelkaK,CatterovdJ,OlejarovdM,etal.Glucosaminesulfateuseanddelayofprogressionofkneeosteoarthritis.ArchInternMed,2002,162:21132212316MendesAF,CaramonaMM,CarvalhoAP,etal.Diacerheinandrheinpre2ventinterleukin21betainducednuclearfactor2kappaBactivationbyin2hibitingthedegradationofinhibitorkappaB2alpha.PharmacolToxicol,2002,91:2222817PelletierJP,YaronM,HaraouiB,etal.Efficacyandsafetyofdiacereininosteoarthritisoftheknee:adouble2blind,placebo2controlledtrial.TheDiacereinStudyGroup.ArthritisRheum,2000,43:2339223481(:2002211208)(:)(Wegenersgranulomatosis,WG),,,WG,WG,,,,1WG:,3720d20001211:,,,(-)::1110109/L,0174;(ESR)104mm/1h,(p2ANCA)(-),(c2ANCA)81102AAU/ml,VCA2IgA1/20(+),OT(-),,,(-),PASCT,,B,,,1226,,,,,,,,,,,2001120()()23:510120,+,,,,62(),,,,,3,,ESR124mm/1h,(RF)334U/ml,C(CRP)58mg/L,p2ANCA(-),c2ANCA99613AAU/ml,ANA(-),,015,0134,WG,,,,,:,,()(X),,1990ACRWGWG6,,WG++3%16%,42%53%,,(ANCA)WG,c2ANCAWG90%,,WG100%,,cANCAWG(:2002206213)(:)2312003373ChinJRheumatol,March2003,Vol7,No.3©1994-2008ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.