摘要
目的:研究戈利木单抗联合来氟米特治疗甲氨蝶呤(MTX)治疗效果不佳的活动性类风湿关节炎(RA)的效果。方法:将医院2016年12月至2018年12月收治的70例MTX治疗效果不佳的活动性RA患者用简单随机分组法分为观察组(戈利木单抗+来氟米特,n=35)与对照组(来氟米特,n=35),观察两组治疗效果。结果:治疗后,两组晨僵时间均显著缩短,关节肿胀及压痛数均显著下降(P<0.05),且观察组治疗后晨僵时间、关节肿胀及压痛数目均显著短于(少于)对照组(P<0.05);治疗后,两组患者及医生视觉模拟疼痛评分(VAS)均较治疗前显著降低(P<0.05),且观察组治疗后患者及医生VAS评分显著低于对照组(P<0.05);治疗后,两组血沉(ESR)、C反应蛋白(CRP)、类风湿因子(RF)水平均较治疗前显著降低(P<0.05),且观察组患者治疗后以上物质水平均显著低于对照组(P<0.05);治疗后,两组血清白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、血浆纤维蛋白/纤维蛋白原降解产物(FDP)及D-二聚体(DD)水平较治疗前显著降低(P<0.05),且观察组治疗后以上各物质水平显著低于对照组(P<0.05);观察组ARC50及ARC70占比明显高于对照组(P<0.05);两组药物不良反应无显著性差异(P>0.05)。结论:伐利木单抗联合来氟米特在MTX治疗效果不佳的活动性RA患者中具有良好的治疗效果,能有效缓解患者晨僵、关节肿胀压痛等临床症状,降低其ESR、CRP、RF及血清相关炎症物质水平,提高治疗效果,且不增加不良反应,值得临床推广。
Objective:To study the effects of golimumab combined with leflunomide in the treatment of active rheumatoid arthritis(RA)with poor treatment effects of methotrexate(MTX).Methods:70 patients with active RA with poor MTX treatment effects in the hospital from December 2016 to December 2018 were divided into observation group(golimumab+leflunomide,n=35)and control group(leflunomide,n=35)according to the simple random grouping.The treatment effects were observed in the two groups.Results:After treatment,the morning stiffness time in the two groups was significantly shortened,and the quantities of joint swelling and tenderness were significantly decreased(P<0.05),and the morning stiffness time and quantities of joint swelling and tenderness in observation group were significantly shorter/Less than those in control group(P<0.05).After treatment,the visual analogue pain scale(VAS)scores of patients and doctors in the two groups were significantly lower than those before treatment(P<0.05),and the VAS scores of patients and doctors in observation group after treatment were significantly lower than those in control group(P<0.05).After treatment,the levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and rheumatoid factor(RF)were significantly lower than those before treatment(P<0.05),and the levels of above substances in observation group were significantly lower than those in control group(P<0.05).After treatment,the levels of serum interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),plasma fibrin/fibrinogen degradation product(FDP)and D-dimer(DD)were significantly lower than those before treatment(P<0.05),and the levels of above substances in observation group after treatment were significantly lower than those in control group(P<0.05).The proportions of ARC50 and ARC70 in observation group were significantly higher than those in control group(P<0.05).There were no significant differences in the adverse drug reactions between the two groups(P>0.05).Conclusion:Golimumab combined with leflunomide has
作者
潘璐
赵华
牛刚
方皓
PAN Lu;ZHAO Hua(West China Nursing College, West China Hospital of Sichuan University, Sichuan Chengdu 610041, China)
出处
《河北医学》
CAS
2020年第2期302-307,共6页
Hebei Medicine
基金
国家自然科学基金，(编号:81401350)
