摘要
目的 观察英夫利西单抗治疗活动性类风湿关节炎（RA）患者前后血清抗酒石酸酸性磷酸酶5b（TRACP-5b）水平，并分析其与RA患者各项活动性指标及疗效的相关性，比较不同抗RA药物对骨侵蚀的影响并阐明可能的机制。方法 36例RA患者随机分为2组，英夫利西单抗治疗组16例，甲氨蝶呤（MTX）治疗组20例，记录所有患者24周的临床及实验室指标。对比2组间及组内血清TRACP-5b水平的差异，并分析其与RA各项活动性指标及疗效的相关性。计量资料组间比较采用秩和检验、成组设计和配对设计的t检验，计数资料采用，检验，相关分析采用Spearman、Pearson相关分析。结果 基线X线表现为Ⅰ、Ⅱ、Ⅲ、Ⅳ期的RA患者血清TRACP-5b水平分别为（1．69±0．48）、（2，64±1．13）、（3．34±1．07）、（4．05±0．25）U／L，Ⅲ、Ⅳ期TRACP-5b水平与Ⅰ期比较差异有统计学意义（P〈O.05）。治疗24周后，英夫利西单抗治疗组血清TRACP-5b水平为（2．16±1．09）U／L，较MTX治疗组[（3．05±0．93）U/L]低，差异有统计学意义（P〈0．05）;较英夫利西单抗组治疗前血清TRACP-5b水平[（3．07±1．32）U／L]低，差异有统计学意义（P〈0．05）。活动性RA血清中TRACP-5b基线水平与病程、健康评价呈正相关（r=0．313，P=0．043；r=0．443，P=0．007）。结论 TRACP-5b血清水平随RA关节X分期增加而升高；血清TRACP-5b的治疗变化可能反映了英夫利西单抗对RA骨破坏的抑制作用。治疗24周后，英夫利西单抗治疗组血清TRACP-5b水平较甲氨蝶呤治疗组明显低，提示英夫利西单抗对破骨细胞的抑制作用可能优于MTX。
Objective To detect the serum level of tartrate-resistant acid phosphatase 5b （TRACP-5b） in patients with rheumatoid arthritis （RA） before and after infliximab treatment and analyze the relevance between TRACP-5b and activity indexes of RA.The effect of different medicines on bony erosion in RA and its possible mechanism were explored. Methods Patients were divided into two groups： 16 patients were treated with infliximab for 24 weeks （group 1 ）, 25 patients were treated with MTX for 24 weeks （group 2）. The core indicators of RA activity were evaluated. Ranked test, grouped design and matched t test was used to examine the quantity data between groups, while numerate data was analyzed with qui-square test. Correlation between data was tested by Spearmen＇s and Pearson＇s tests. Results The levels of TRACP-5b in patients with X-ray stages Ⅰ , Ⅱ , Ⅲ , Ⅳ were elevated at the baseline. The levels of TRACP-5b in phase Ⅲ and Ⅳ were [（3.34±1.07） U/L] and [（4.05±0.25） U/L] respectively, higher （P〈0.05） than those in phase Ⅰ [（1.69±0.48） U/L]. At week 0, week 12, and week 24, the serum levels of TRACP-Sb in group 1 were （3.07±1.32）, （2.72±1.18）, （2.16±1.09） U/L respectively, while the levels in week 12, and 24 were significantly lower than those of week 0 （P〈0.05）. A significant decrease of serum TRACP-Sb level in group 1 [（2.16±1.09） U/L] when compared to group two [ （3.05±0.93） U/L] after 24 weeks. TRACP-5b level was positively correlated with the course of disease （r=0.313, P=0.043）, HAQ（r=0.443, P=0.007）. Conclusion Infliximab can reduce TRACP-5b level in RA and inhibit inflammatory bone loss. TRACP-5b can be used to evaluate the efficacy of biological agents in treating RA.
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2011年第2期87-90,共4页
Chinese Journal of Rheumatology
