摘要
目的探讨小剂量肾上腺糖皮质激素(glucocorticoid,GC)与注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白短期联合应用治疗类风湿关节炎(rheumatoid arthritis,RA)的临床效果。方法选取2015年1月至2016年8月在我院接受治疗的RA患者50例,采用随机数表法分为观察组和对照组各25例。对照组给予注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗,观察组给予小剂量GC联合注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗,观察两组治疗前后视觉模拟评分(VAS)、健康评估问卷评分(HAQ)、C反应蛋白(CRP)、疾病活动指数28(DAS28)、压痛关节数(TJC)以及肿胀关节数(SJC)改善情况,比较治疗前后红细胞沉降率、类风湿因子、握力和僵持时间及不良反应。结果治疗后,两组VAS、CRP、TJC、SJC、红细胞沉降及类风湿因子均下降,且观察组低于对照组;HAQ指标、DAS28评分、握力均提高,且观察组高于对照组(P<0.05);僵持时间均缩短,且观察组短于对照组(P<0.05)。两组治疗后不良反应差异无统计学意义(P>0.05)。结论小剂量GC联合注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗RA,能够有效改善患者的疼痛改善,不良反应发生率低,效果显著,值得临床推广使用。
Objective To investigate the clinical effect of short-term treatment of combined small dose of glucocorticoid （GC） and etanercept for rheumatoid arthritis （RA）. Methods Fifty RA patients who were treated in our hospital from January 2015 to August 2016 were selected, and randomly divided into observation or control group,25 in each group. The control group was treated with etanercdpt only while the observation group was treated with low dose GC combined with etanercept. The improvement of VAS, HAQ, CRP, DAS28,TJC and SJC before and after treatment were observed in the two groups. At the same time, the erythrocyte sedimentation rate, rheumatoid factor and hand grip strength and stalemate time before and after treatment were compared, as well as adverse reaction rate was observed. Results After treatment,in both groups,the VAS, CRP TJC, SJC, erythrocyte sedimentation rate and rheumatoid factor were decreased, the HAQ index, DAS28 score and hand grip strength were increased and the stalemate time was shortened. Interestingly, all the indexes in the observation group was lower or higher or shorter than those in the control group （all P〈0.05 ）. However, there was no statistical difference in the incidence of adverse reactions between the two groups （ P〉0.05 ）. Conclusion Combination of small doses of GC and etanercept for RA patients can effectively improve the patient＇s pain with low incidence of adverse reactions. The effect is significant, and it is worthy of clinical use.
出处
《实用医院临床杂志》
2017年第6期232-235,共4页
Practical Journal of Clinical Medicine
