摘要
目的研究甲氨蝶呤联合甲泼尼龙治疗对老年类风湿关节炎(RA)患者脑白质疏松部位及程度的影响。方法选取2019年5月~2020年5月就诊于西安市第五医院的115例老年RA患者,采用随机数字表法分为口服甲氨蝶呤的对照组(57例)和口服甲氨蝶呤联合口服甲泼尼龙的联合组(58例),两组均完善头颅磁共振成像(MRI)明确脑白质疏松部位和程度,治疗1年后再次复查头颅MRI评估脑白质疏松部位及程度。结果治疗前后,两组脑白质疏松、脑室旁白质损害(PWMLs)和脑深部白质损害(DWMLs)出现比例比较,差异均无统计学意义(P>0.05)。治疗前两组脑白质疏松、PWMLs及DWMLs严重程度评分比较,差异均无统计学意义(P>0.05);治疗后,联合组脑白质疏松及DWMLs严重程度评分均低于对照组(P<0.05),两组PWMLs严重程度评分比较差异无统计学意义(P>0.05)。结论甲氨蝶呤联合甲泼尼龙可减缓老年RA患者脑白质疏松的进展,在减轻白质疏松程度同时对深部脑白质具有明显的保护作用。
Objective To study the effect of Methotrexate combined with Methylprednisolone on the location and degree of leukoaraiosis in older patients with rheumatoid arthritis(RA).Methods A total of 115 older patients with RA admitted to Xi’an Fifth Hospital from May 2019 to May 2020 were included in this study.The patients were randomly divided into a control group(57 patients receiving oral Methotrexate)and a combination group(58 patients receiving oral Methotrexate and Methylprednisolone).The cranial MRI was performed in the two groups to determine the location and degree of leukoaraiosis.After one year of treatment,the cranial MRI was re-performed to evaluate the changes of location and degree of leukoaraiosis.Results Before and after treatment,there were no significant differences between the two groups in the proportions of patients with leukoaraiosis,periventricular white matter lesions(PWMLs)or deep white matter lesions(DWMLs)(P>0.05).Before treatment,there were no significant differences in the score of leukoaraiosis,PWMLs or DWMLs between the two groups(P>0.05).After treatment,the scores of leukoaraiosis and DWMLs in the combination group were lower than those in the control group(P<0.05).There was no significant difference in PWMLs score between the two groups(P>0.05).Conclusion Methotrexate combined with Methylprednisolone may slow down the progression of leukoaraiosis,reduce the degree of leukoaraiosis,and has a significant protective effect on deep brain white matter in older patients with RA.
作者
闫俊
朱葛敏
高亚亚
周辉
李娟
刘丹
Yan Jun;Zhu Gemin;Gao Yaya;Zhou Hui;Li Juan;liu Dan(Department of Neurology,Xian Fifh Hopital,Xian 710082;Departmnent of Neurology,Xian Central Hospital,Xian 70002;Department of Rheumatology and Immunology,Xian Fifth Hospital,Xian 710082)
出处
《国际老年医学杂志》
2023年第1期53-56,共4页
International Journal of Geriatrics
基金
陕西省自然科学基础研究计划重点项目(2021JZ-59)
陕西省重点研发计划项目(2021SF-259)
西安市第五医院院内课题(2021lc03)
西安市科技局社会发展引导计划[2017118SF/YX012(7)]。
