title: [Therapeutic response of radiosynovectomy with p-32 colloid in 326 patients with hemophilic arthropathy].
abstract: Objective:To observe the therapeutic response of radiosynovectomy with p-32 colloid on hemophilic arthropathy, and to assess the effects of radiosynovectomy with Denver Score on hemophilic arthritis staging.Methods:Radiosynovectomy with p-32 colloid was performed on 326 hemophilic arthritis patients (405 joints) , and recorded bleeding before and after treatment. The MRI performance of 102 joints was evaluated by using Denver scoring system, then was divided into 0-6 and 7-10 groups. Finally, the differences between 2 groups were analyzed.Results:Average pain score of all hemophilic arthritis patients at 6 months, 1, 2 and 3 years post treatment decreased from 3.2±2.4 (n=326) to 1.2±0.6 (n=285,P=0.021) , 1.7±0.5 (n=242,P=0.032) , 2.1±1.1 (n=212,P=0.030) and 2.2±1.6 (n=176,P=0.037) , respectively. The frequency of bleeding in 405 joints at 1, 2 and 3 years post treatment decreased from 15.1±3.6 to 2.1±0.7, 4.3±0.6, and 4.8±0.8 times per year (P<0.01) , respectively; Meanwhile, the proportions of significantly ameliorated joints' activities were observed as of 68.50% (248/362) , 58.39% (181/310) , 55.67% (162/239) and 42.61% (75/176) , respectively. The frequencies of haemarthrosis at 1 and 2 years post treatment in patients with 0-6 Denver Score (45 target joints) reduced from 13.0±1.9 to 1.3±0.6 (P=0.002) and 3.1±0.9 (P=0.009) times per year, respectively, which also decreased in 7-10 group (57 target joints) from 16.6±2.1 to 3.1±0.9 (P=0.008) and 5.7±1.1 (P=0.004) times per year, respectively. There was no statistical difference between 0-6 and 7-10 groups before treatment in the terms of haemarthrosis frequency (P=0.773) . However, 7-10 group had higher haemarthrosis frequency at 1 and 2 years post treatment compare with 0-6 group (P=0.028 and 0.042, respectively) . Synovial volumes in 29 joints reduced after 6 month when compared with baseline [ (2 362.15±32.41) mm(3)vs(3 012.40±39.78) mm(3),t=7.621,P<0.001].Conclusion:Radiosynovectomy with p-32 colloid on haemophilic synovitis was a safe and effective procedure. The patients with Denver Score of 0-7 had lower frequency of haemarthrosis.
authors.affiliation: Department of Hematology, Henan Province People's Hospital, Zhengzhou 450003, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: Y H
authors.initials: YH
authors.lastname: Ge
authors.forename: H J
authors.initials: HJ
authors.lastname: Liu
authors.forename: Y H
authors.initials: YH
authors.lastname: Liu
authors.forename: J J
authors.initials: JJ
authors.lastname: Zhao
authors.forename: Y C
authors.initials: YC
authors.lastname: Dou
authors.forename: P C
authors.initials: PC
authors.lastname: Lei
mesh_terms: D000293:Adolescent; D001168:Arthritis; D003102:Colloids; D006395:Hemarthrosis; D006402:Hematologic Diseases; D006467:Hemophilia A; D006801:Humans; D013585:Synovitis
chemical_list: D003102:Colloids
keywords: Hemophilia A; Hemophilia B; Magnetic resonance imaging; Phosphorus radioisotopes; Synovitis