摘要
目的探讨硫酸羟氯喹治疗老年类风湿关节炎的疗效及对患者炎症、自身抗体的影响。方法选择2017年1月至2018年10月解放军联勤保障部队第九四〇医院收治老年类风湿关节炎患者126例,按照随机数字表法分成2组,每组63例。对照组采用甲氨蝶呤+来氟米特治疗,观察组在对照组的治疗基础上加用硫酸羟氯喹治疗。比较治疗后2组临床疗效,症状体征改善情况,炎症因子水平变化、自身抗体水平变化及治疗安全性。结果治疗前,2组患者关节疼痛度、晨僵时间、关节肿胀数、关节压痛数、血清炎症因子水平、自身抗体等指标差异均无统计学意义(P>0.05)。治疗后,观察组临床总有效率明显高于对照组(P<0.05);2组患者关节疼痛度、晨僵时间、关节肿胀数、关节压痛数、血清炎症因子水平、自身抗体等指标均较治疗前降低(P<0.05);其中观察组上述指标均明显低于对照组(P<0.05);观察组患者总不良反应发生率(6.35%)明显低于对照组(19.05%)(P<0.05)。结论在甲氨蝶呤与来氟米特治疗基础上,加用硫酸羟氯喹的治疗方案能更有效地改善老年类风湿关节炎患者炎症症状,减轻患者自身抗体水平,疗效显著,安全性高,在临床上的应用价值高。
Objective To discuss the efficacy of hydroxychloroquine sulfate in the treatment of rheumatoid arthritis and its effect on inflammation and autoantibody in senile patients.Methods One hundred and twenty-six senior patients with rheumatoid arthritis admitted to the hospital from January 2017 to October 2018 were randomly and equally divided into 2 groups,each consisting of 63 patients.The control group was treated with methotrexate+leflunomide,while the observation group was treated with hydroxychloroquine sulfate on the basis of the treatment as taken by the control group.Clinical efficacy,improvement in signs and symptoms,changes in inflammatory cytokines,changes in autoantibody level and treatment safety were compared between the 2 groups.Results Before treatment,there were no significant differences in the seriousness of joint pain,morning stiffness,joint swelling,joint tenderness,serum inflammatory factor level,as well as autoantibody in the patients of the 2 groups(P>0.05).Following treatment,the total clinical effective rate of the observation group was significantly higher than that of the control group(P<0.05).The seriousness of joint pain,the time of morning stiffness,the number of joint swelling,the number of joint tenderness,the level of serum inflammatory factor and such indicators as autoantibody were all lower as compared with those before treatment(P<0.05).The above indexes in the observation group were significantly lower than those in the control group(P<0.05),and the rate of total adverse reactions in the observation group(6.35%)was significantly lower than that in the control group(19.05%)(P<0.05).Conclusion On the basis of methotrexate and leflunomide treatment,complementary treatment with hydroxychloroquine sulfate could effectively improve inflammatory symptoms of elderly patients with rheumatoid arthritis,reduce autoantibody level and achieve significant curative effect,with good safety and high clinical application value.
作者
赵金英
吴小芬
杜军
韩凤霞
王可敬
苏建
彭晓东
陈波
Zhao Jinying;Wu Xiaofen;Du Jun;Han Fengxia;Wang Kejing;Su Jian;Peng Xiaodong;Chen Bo(Department of Endocrinology and Rheumatology,No.940 Hospital of Joint Logistics Support Force of People's Liberation Army,Lanzhou 730050,China)
出处
《海军医学杂志》
2020年第6期699-703,共5页
Journal of Navy Medicine
关键词
硫酸羟氯喹
老年类风湿关节炎
炎症反应
自身抗体
临床疗效
Hydroxychloroquine sulfate
Senile rheumatoid arthritis
Inflammatory response
Autoantibody
Clinical efficacy
