Preliminary Explore The Relationship Between Hemophilic Arthropathy Of 31 Cases And Prophylaxis On Yunnan Province

[Objective]Illuminate its preventive treatment effect on joint deformities with hemophilia patients in yunnan province,we can get appropriate therapeutic regimen to hemophilia patients,which is in order to reduce or avoid unnecessary bleeding risk for joints,improve the prognosis of patients with hemophilia,and improve the quality of life in patients with hemophilia.We can provide a preventive treatment solution to hemophiliacs for each hemophilia treatment and management center in yunnan province,as well.[Methods]Assess the patients' quality of life by the quality of life scale of PedsQL,joint bleeding times and joint disease assessment by ultrasonic,Yunnan hemophilia patients are admitted to hemophilia case management center registration and administration of the first affiliated hospital of kunming medical university:Patients are divided into preventive treatment group and on-demand treatment group.With the lower doses for preventive treatment of hemophilia A is rF?10-15 U/kg.d,twice weekly,along for six months;With the lower doses for preventive treatment of hemophilia B is rF IX 10-20U/kg.d,twice weekly,last for six months;The doses for on-demand treatment of hemophilia A is rF?:Weight(kg)X need to improvelevel÷two;The doses for on-demand treatment of hemophilia B is rF?:Weight(kg)X need to improvelevel.By screening and grouping each group performers questionnaire survey,telephone tracking and regular follow-up,respectively and joint ultrasound for hemophilia patients for at the same time.Compare results of the two groups by SPSS22.0 statistical software for data statistics analysis,the patients' clinical information gathered by questionnaire data and ultrasound examination,so it is achieved the plan of preventative treatment to hemophiliac arthropathy in yunnan province.[Results]1.Articular structural stateAnalyze the difference between the preventive treatment and on-demand treatment by observation condition of joints ultrasound exam with the prevention and treatment of 11 cases with small dose in patients with hemophilia and articular damage situation of 9 cases of patients with on-demand treatment of hemophilia.Evaluate differences of the two groups by assessment method of joint ultrasound;including the following aspects:seepage;joint effusion or hemorrhage,fibre diaphragm,synovial hyperplasia,synovial thickening with synovial proliferation and hemosiderin deposition.Joint damage of preventive treatment group of patients is lighter than that of demand treatment group.2.Results of total arthrorrhagia times:The mean of arthrorrhagia times of preventive treatment group is 4.29 per year,while the mean of arthrorrhagia times of on-demand treatment group is 15.14 P-0.001(<0.05),which suggests there are statistical significance between two groups,implying preventive treatment evidently decreases its arthrorrhagia times3.Target arthrorrhagia numbers:Counting total target numbers of joints bleeding during study period to the prevention and treatment of 11 cases patients with hemophilia patients and the prevention and treatment of 9 cases of hemophilia.total target numbers of joints bleeding X 2 equal the total number of target joints per year.the result is:the mean number of target joints bleeding of the prevention of the treatment group is 1.5(b),that of on-demand treatment group is 4.0,(P = 0.003<0.05),which indicates the preventive treatment can reduce the number of target joint bleeding.4.Consume amount of coagulation factor:Computer amount of coagulation factor consuming per year(IU/kg/year),the mean of that of preventive treatment group is 682.7(IU/kg/year),the mean of on-demand treatment groupis 886.5(IU/kg/year),which imply o preventive treatment tendency to reduce amount of coagulation factor consuming.5.Quality of life:5.1?11 cases,preventive treatment group is 5 cases,on-demand treatment groups 6 cases.We exam statistics of the numbers by exact propability of four-fold table P=0.242,P>0.05,there are not statistical significance,but the effective probability of preventive treatment group(60%),the effective probability of on-demand treatment group(15%)which suggest quality of life of preventive treatment group is not better than that of on-demand treatment group.5.2.Sick days(d/year).The mean of that of preventive treatment group is 12.1days,that of on-demand treatment group is 39.6 days,P=0.015,P<0.05,there are statistical significance,which imply small dosage of preventive treatment can reduce sick days.6.Inhibitor generated rate:There are not statistical significance between preventive treatment group and on-demand treatment group.The results show both of the groups are not inhibitor generated.[Conclusions]The conclusions are as following by the case control;preventive treatment can reduce joint damage,times of arthrorrhagia,numbers of arthrorrhagia and sick days;both of groups of coagulation factor consuming and quality of life are not statistical significance?There are ameliorative trend to quality of life of preventive treatment groups.We enlarge sample size to further analyze its results.both of the groups are not inhibitor generated,lengthen observing time to analyze.