摘要
目的探讨甲氨蝶呤联合重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对类风湿关节炎患者临床疗效的影响。方法纳入2017年1月-2019年1月本院确诊为类风湿关节炎的患者84例,根据治疗方法不同分成对照组与观察组,每组均为42例;对照组给予甲氨蝶呤(7.5 mg/周)联合硫酸羟氯喹(0.4 g/d)治疗,观察组予甲氨蝶呤(7.5 mg/周)联合重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(50 mg/周)治疗,观察12周。对比两组治疗前后类风湿因子、C反应蛋白、血沉、抗环瓜氨酸肽抗体、关节肿胀个数、关节压痛个数、28个关节疾病活动度评分、视觉模拟评分、滑膜增生评分、骨侵蚀评分、滑膜血流评分、关节积液评分的变化。结果 (1)治疗后两组患者类风湿因子、C反应蛋白、血沉、抗环瓜氨酸肽抗体均较治疗前明显下降,且观察组下降幅度大于对照组。(2)治疗后两组28个关节疾病活动度评分、关节肿胀个数、关节压痛个数、视觉模拟评分均较治疗前明显下降,且观察组下降幅度大于对照组。(3)治疗后两组患者滑膜增生评分、骨侵蚀评分、滑膜血流评分、关节积液评分均较治疗前明显下降,且观察组下降幅度大于对照组。结论甲氨蝶呤联合重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白可显著改善类风湿关节炎患者的临床症状,减轻炎症反应,提高临床疗效。
Objective To investigate the the clinical effect of methotrexate combined with recombinant human TNF receptorⅡ: IgG Fc fusion protein on the patients with rheumatoid arthritis. Methods There were 84 patients with rheumatoid arthritis who were diagnosed from January 2017 to January 2019 in the department of rheumatology of our hospital were selected for the study. They were randomly divided into the control group and the observation group according to the diffferent therapeutic methods. 42 cases in the control group were treated with methotrexate(7.5 mg/week) combined with hydroxychloroquine sulfate(0.4 g/day), and 42 cases in the observation group were treated with methotrexate(7.5 mg/week) combined with recombinant human TNF receptorⅡ: IgG Fc fusion protein(50 mg/week). The levels of rheumatoid factor(RF)、C-reaction protein(CRP), erythrocyte sedimentation rate(ESR) and Anti-cyclic citrullinated peptide antibodies(ACPA), the number of joint swelling(SJC) and joint touch pain(TJC), the 28 disease activity score(DAS28)、visual analogue scale(VAS)、synovial hyperplasia score(SHS)、boneerosion score(BES)、synovial blood flow score(SBFS) and Joint effusion score(JES) were compared betwen the two groups after the 12 weeks. Results(1)After the intervention, the levels of RF、CRP、ESR and ACPA decreased significantly in the two groups, and the observation group was lower than the control group.(2)After the intervention, the levels of SJC、TJC、DAS28 and the VAS decreased significantly in the two groups, and the observation group was lower than the control group.(3)After the intervention, the levels of SHS、BES、SBFS and the JES decreased significantly in the two groups,and the observation group was lower than the control group.Conclusion Methotrexate combined with recombinant human TNF receptorⅡ: IgG Fc fusion protein on the patients with rheumatoid arthritis can significantly relief the clinical symptoms, reduce inflammation and improve clinical efficacy.
作者
吴文胜
温翠英
WU Wensheng;WEN Cuiying(Department of Rheumatology,The Second Hospital of Sanming,Yong’an Fujian 366000,China)
出处
《中国卫生标准管理》
2019年第22期76-78,共3页
China Health Standard Management
