Intra-articular distribution of admistrated hematoporphirine in rheumatoid arthritis and selective synovialdesis using an argon-dye laser

(1)注射佐剂引起大鼠佐剂性关节炎后第14天，观察给药血卟啉（HPD）在关节内的分布，此时炎症反应最大。用2、3w氩染料激光照射滑膜产生680微米的荧光，证实滑膜中存在HPD。HPD在佐剂性关节炎滑膜中的分布在给药后24-48小时达到最大值。HPD在佐剂性关节炎中的分布是正常对照的10倍以上。(2)关节镜下滑膜切断术获得人滑膜组织，并进行培养。在培养基中加入HPD，氩气染料激光照射成功地阻碍或抑制了组织的生长。(3)类风湿性关节炎患者静脉给予HPD 2 mg /kg，注射HPD 48 h后经氩染料激光关节镜照射。术后6个多月，出现关节积水复发。(4) HPD不仅分布在关节滑膜上，而且分布在整个身体上，因此，应仔细保护皮肤，防止晒伤。这名患者被隔离在阳光下一周，并服用大量维生素C。然而，病人仍然遭受严重的晒伤。如何防止晒伤需要进一步的研究。我们认为关节内注射HPD优于静脉注射，因为它更容易被滑膜组织吸收，而在皮肤上的分布更少。(5)双侧滑膜炎患者一侧仅行关节镜下滑膜切除术，另一侧关节镜下滑膜切除术增强HPD注射和氩染料激光照射。后者显然取得了更好的效果。HPD被认为是由农业染料激光激活并破坏细胞，然而，过程的细节需要进一步研究。治疗后滑膜组织出现退变。少

(1) Intra-articular distribution of administrated hematoporphirine (HPD) was examined on 14th day after adjuvant injention to cause the adjuvant arthritis of a rat, when the maximum inflamation was found. Existence of HPD in the synovium was demonstrated by fluorescence of 680 micrometer evoked after irradiation of 2 or 3 W of argon-dye laser light. Distribution of HPD in the adjuvant arthritic synovium was found maximun 24-48 hours after HPD administration. HPD distribution in the adjuvant arthritis was found more than 10 times comparing with the normal control.(2) The human synovial tissue was obtained during arthroscopis synoventomy, and was cultured. Admistration of HPD into the culture medium, and irradiation of argon-dye laser successfully impeded or suppressed the tissue growth.(3) A patient with rheumatoid arthritis was admistrated with HPD 2 miligram/kg intravenously, and irradiated by argon-dye laser arthroscopically 48 hours after the HPD injection. Good results were obtaine … More d for 6 months, however, recurrence of the hydroarthrosis took place.(4) HPD was distributed over not only the joint synovium but whole of the body, therefore, careful protection of the skin from sun burn should be employed. This patient was secured from sun light for a week, and massive vitamine C was administrated. However, the patient still suffered from severe sun burn. The way how to protect from sun burn required furhter investigation. It was considered that intra-articular injection of HPD was superior to intravenous administration, because of more absorption into the synovial tissue and less distribution over the skin.(5) A patient with bilateral synovitis was treated with just arthroscopic synovectomy for one side, and arthroscopic synovectomy augumented with HPD injection and argon-dye laser irradiation for the other. The latter obviosly obtained better results. HPD was considered activated by agron-dye laser light and destroyed cells, however, details of the process needed further investigation. Degeneration of the synovial tissue was demonstrated after this treatment. Less