摘要
目的探讨硫酸羟氯喹联合吡非尼酮对类风湿关节炎合并间质性肺疾病患者肺功能及炎性因子水平的影响。方法选取于2018年2月至2021年5月接受治疗的104例中重度类风湿关节炎合并间质性肺疾病患者为研究对象,按照随机数字表法分为对照组和观察组,每组52例。对照组给予羟氯喹治疗,观察组在对照组的基础上加用吡非尼酮治疗。观察或检测2组患者治疗前后的临床表现、血清中C反应蛋白(CRP)、红细胞沉降率(ESR)、D-二聚体(D-D)、类风湿因子(RF)、涎液化糖链抗原(KL-6)水平、肘关节受累情况以及肺功能。结果治疗后2组患者临床表现均较前改善,且观察组患者晨僵时间、关节肿胀及压痛数均显著低于对照组(P<0.05);治疗后观察组患者血清CRP、ESR、D-D和RF表达水平显著低于对照组患者(P<0.05);治疗后观察组患者血清KL-6表达水平显著低于对照组患者(P<0.05)。治疗6个月后观察组患者彩色超声多普勒改善较对照组患者明显(P<0.05);并且观察组患者动脉血氧分压、肺活量明显高于对照组(P<0.05)。结论硫酸羟氯喹联合吡非尼酮能够明显改善类风湿关节炎合并间质性肺疾病患者的临床表现,降低血清CRP、RF、D-D和ESR水平,抑制炎症反应,降低血清KL-6表达水平,改善肺功能,同时延缓肘关节损伤。
AIM To explore the effect of hydroxychloroquine sulfate combined with pirfenidone on lung function and inflammatory factor levels of patients with rheumatoid arthritis(RA)combined with interstitial lung disease(ILD).METHODS A total of 104 patients with moderate to severe RA complicated with ILD treated from February 2018 to May 2021 were selected as study subjects.According to the random number table method,the patients were divided into control group and observation group,with 52 patients in each group.In the control group hydroxychloroquine was given,and on the basis of the control group treated with pirfenidone in the observation group.Clinical effect,serum C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR),D-Dimer(D-D),rheumatoid factor(RF)and serum Krebs von den Lungen-6(KL-6)levels were compared between 2 groups.Color Doppler ultrasonography of elbow joint and pulmonary function changes were compared between 2 groups.RESULTS After treatment,the clinical manifestations of 2 groups were improved,and the time of morning stiffness,joint swelling and tenderness of patients in the observation group were significantly lower than those in the control group(P<0.05).In addition,the serum CRP,ESR,D-D and RF expression levels of the observation group were significantly lower than those of the control group(P<0.05).After treatment,the serum KL-6 expression level in the observation group was significantly lower than that in the control group(P<0.05).Observation group showed better improvement in color doppler ultrasound than control group after 6 months treatment(P<0.05).And the arterial partial pressure of oxygen and vital capacity of patients in the observation group were significantly higher than those in the control group after treatment(P<0.05).CONCLUSION Hydroxychloroquine combined with pirfenidone sulfate can significantly improve the clinical performance of patients with RA complicated with ILD,reduce serum CRP,RF,D-D,ESR expression levels,inhibit inflammatory response,reduce serum KL-6 expression lev
作者
孙志娟
赵新伟
胡利伟
张静阳
刘俊兰
SUN Zhijuan;ZHAO Xinwei;HU Liwei;ZHANG Jingyang;LIU Junlan(The Second Department of Rheumatism,Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou 061001,China)
出处
《中国临床药学杂志》
CAS
2022年第10期756-760,共5页
Chinese Journal of Clinical Pharmacy
基金
河北省卫健委青年科技课题(编号20191285)
关键词
硫酸羟氯喹
吡非尼酮
类风湿关节炎
间质性肺疾病
肺功能
炎性因子
hydroxychloroquine sulfate
pirfenidone
rheumatoid arthritis
interstitial lung disease
lung function
inflammatory cytokine
