摘要
目的:观察阿达木单抗注射液联合来氟米特治疗老年类风湿关节炎(RA)患者的效果。方法:选取2021年3月至2023年3月该院收治的87例老年RA患者进行前瞻性研究,按随机数字表法将其分为对照组43例与研究组44例。对照组采用来氟米特治疗,研究组在对照组基础上联合阿达木单抗注射液治疗。比较两组临床疗效,治疗前后临床症状、疾病相关指标[红细胞沉降率(ESR)、类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体]水平、炎性指标[巨噬细胞集落刺激因子(M-CSF)、白细胞介素-1β(IL-1β)、C反应蛋白(CRP)、环氧合酶-2(COX-2)]水平、核因子-κB(NF-κB)通路相关指标[NF-κB激活剂1(Act1)、NF-κB、NF-κB抑制蛋白α(IκBα)]水平,以及不良反应发生率。结果:研究组治疗总有效率为93.18%(41/44),高于对照组的74.42%(32/43),差异有统计学意义(P<0.05);治疗后,两组晨僵时间均短于治疗前,且研究组短于对照组,两组关节压痛度、关节肿胀度、关节疼痛度评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组ESR、RF、抗CCP抗体水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组血清M-CSF、IL-1β、CRP、COX-2水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组外周血Act1、NF-κB、IκBα mRNA水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:阿达木单抗注射液联合来氟米特治疗老年RA患者可提高治疗总有效率,改善临床症状,降低疾病相关指标、炎性指标和NF-κB通路相关指标水平,其效果优于单纯来氟米特治疗。
Objective:To observe effects of Adalimumab injection combined with Leflunomide in treatment of elderly patients with rheumatoid arthritis(RA).Methods:A prospective study was conducted on 87 elderly patients with RA admitted to the hospital from March 2021to March 2023.According to the random number table method,they were divided into control group(43 cases) and study group(44 cases).The control group was treated with Leflunomide,while the study group was treated with Adalimumab injection on the basis of that of the control group.The clinical efficacy,the clinical symptoms and the disease-related indexes [erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),anticyclic citrullinated peptide(CCP) antibody] levels,the inflammatory factor [macrophage colony stimulating factor(M-CSF),interleukin-1β(IL-1β),C-reactive protein(CRP),cyclooxygenase-2(COX-2)] levels,the nuclear factor-κB(NF-κB) pathway-related indexes [NF-κB activator(Act1),NF-κB,NF-κB inhibitory protein α(IκBα)] levels,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the study group was 93.18%(41/44),which was higher than 74.42%(32/43) of the control group,and the difference was statistically significant(P<0.05).After the treatment,the morning stiffness time of the two groups was shorter than that before the treatment,and that of the study group was shorter than that of the control group;the scores of joint tenderness,joint swelling and joint pain in the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group;and the differences were statistically significant(P<0.05).The levels of ESR,RF and anti-CCP antibody in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of serum M-CSF,IL-1β,CRP and COX-2 in the two groups were lower than those be
作者
闫亚璞
YAN Yapu(Department of Rheumatology and Immunology of Ruzhou Orthopedic Hospital,Pingdingshan 467500 Henan,China)
出处
《中国民康医学》
2024年第13期57-60,64,共5页
Medical Journal of Chinese People’s Health
