摘要
目的探讨羟氯喹联合吡非尼酮治疗老年类风湿关节炎(RA)合并间质性肺炎(IP)的临床效果。方法选取2018年3月—2021年3月收治的老年RA合并IP 74例,按治疗方法不同分为研究组和对照组各37例,对照组采取吡非尼酮治疗,研究组在对照组基础上联合羟氯喹治疗,6个月后观察并比较2组临床疗效,治疗前后临床症状体征、急性时相反应物、动脉血气指标、肺功能指标,以及用药不良反应。结果治疗后,研究组治疗有效率为94.59%(35/37)显著高于对照组的72.97%(27/37)(P<0.05)。治疗后2组晨僵时间、病情活动度评价表评分、视觉模拟评分法评分、关节肿胀计数均缩短或减少,且研究组短于或少于对照组(P<0.05)。治疗后,2组C反应蛋白、红细胞沉降率、类风湿因子、Ⅰ型胶原氨基末端肽水平明显降低,且研究组低于对照组(P<0.05)。2组氧合指数、用力肺活量、每分钟最大通气量、肺一氧化碳弥散量水平均明显升高,且研究组明显高于对照组(P<0.05)。研究组不良反应少于对照组(P<0.05)。结论羟氯喹联合吡非尼酮治疗能缓解老年RA合并IP患者临床症状,降低急性时相反应物水平,改善动脉血气指标及肺功能,控制不良反应的发生。
Objective To explore the clinical effect of Hydroxychloroquine Sulfate combined with Pirfenidone in the treatment of senile rheumatoid arthritis(RA)complicated with interstitial pneumonia(IP).Methods A total of 74 elderly patients with RA and IP admitted from March 2018 to March 2021 were divided into research group(n=37)and control group(n=37)according to different treatment methods.The control group was treated with Pirfenidone,and the research group was treated with Hydroxychloroquine Sulfate on the basis of the control group.The clinical efficacy of the two groups was observed and compared at 6 months after treatment.Clinical symptoms and signs,acute phase reactants,arterial blood gas indexes,lung function indexes,and adverse drug reactions before and after treatment were compared.Results After treatment,the effective rate of the research group was significantly higher than that of the control group[94.59%(35/37)vs.72.97%(27/37)](P<0.05).After treatment,morning stiffness time,disease activity score of SRA,visual analog score and joint swelling count were shortened or decreased in the two groups,especially in the research group(P<0.05).After treatment,the levels of C-reactive protein,erythrocyte sedimentation rate,rheumatoid factor and amino terminal peptide of typeⅠcollagen in the two groups were significantly decreased,which were lower in the research group was than in the control group(P<0.05).The oxygenation index,forced vital capacity,maximum ventilatory volume/minute and diffusing capacity of the lungs for carbon monoxide were significantly increased in the two groups,which were significantly higher in the research group than in the control group(P<0.05).The incidence of adverse reactions in the research group was lower than that in the control group(P<0.05).Conclusion Hydroxychloroquine Sulfate combined with Pirfenidone can relieve clinical symptoms,reduce acute phase reactant levels,improve arterial blood gas indexes and lung function,and control the occurrence of adverse reactions in patients with S
作者
孙志娟
赵新伟
胡丽伟
张静阳
刘俊兰
SUN Zhijuan;ZHAO Xinwei;HU Liwei;ZHANG Jingyang;LIU Junlan(Department of Rheumatology and Immunology,Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Cangzhou,Hebei 061000,China)
出处
《转化医学杂志》
2023年第3期194-198,203,共6页
Translational Medicine Journal
基金
河北省卫生健康委科研基金项目(20191285)。
关键词
关节炎
类风湿
肺疾病
间质性
老年人
羟氯喹
吡非尼酮
C反应蛋白
氧合指数
药物毒性
Arthritis,rheumatoid
Lung diseases,interstitial
Aged
Hydroxychloroquine
Pirfenidone
C reactive protein
Oxygenation index
Drug toxicity
