摘要
目的:研究难治性类风湿关节炎(RRA)治疗中双醋瑞因与艾拉莫德联合疗效及对患者辅助性T细胞17(TH17)/调节性T淋巴细胞(Treg)的影响。方法:回顾性分析2021年1月至2023年12月入院的80例RRA患者,根据不同治法分为单一组(单用艾拉莫德,40例)与联合组(联用艾拉莫德、双醋瑞因,40例);比较两组治疗前后血清学指标[白细胞介素-17(IL-17)、TH17、Treg、TH17/Treg]、血清炎症因子[C-反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-1(IL-1)]、免疫学指标[免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)]、实验室指标[人内皮抑素(ES)、类风湿因子(RF)、红细胞沉积率(ESR)]、临床症状改善状况(关节肿胀数量、晨僵时间、关节疼痛(VAS)评分)与治疗后总有效率、不良反应(白细胞减少、恶心呕吐、瘙痒、皮疹)发生率。结果:与单一组比较,联合组治疗后IL-17、TH17、TH17/Treg、CRP、TNF-α、IL-1β、IL-1、IgM、IgA、IgG、RF、ESR与关节肿胀数量、VAS评分更低,Treg、ES更高,晨僵时间更短,差异有统计学意义(P<0.05)。联合组治疗后总有效率(97.50%)高于单一组(80.00%),差异有统计学意义(P<0.05)。两组白细胞减少、恶心呕吐、瘙痒、皮疹发生率差异无统计学意义(P>0.05)。结论:RRA治疗中双醋瑞因与艾拉莫德联合疗效显著,有益于进一步改善患者炎症因子、免疫学指标及实验室指标与减轻症状,还可纠正TH17/Treg失衡,且不良反应少。
Objective:To investigate the efficacy of diacreine combined with eramode in the treatment of refractory rheumatoid arthritis(RRA)and the effects on helper T cell 17(TH17)/regulatory T lymphocyte(Treg)in patients.Methods:A total of 80 patients with RRA admitted to hospital from January 2021 to December 2023 were retrospectively analyzed and divided into single group(40 cases with eramodide alone)and combined group(40 cases with eramodide and diacerein)according to different treatment methods.Serological indexes[interleukin-17(IL-17),TH17,Treg,TH17/Treg],serum inflammatory factors[C-reactive protein(CRP),tumor necrosis factor(TNF-α),interleukin-1β(IL-1β),interleukin-1(IL-1)]and immunological indexes were compared between the two groups before and after treatment[Immunoglobulin]M(IgM),immunoglobulin A(IgA),immunoglobulin G(IgG)],laboratory indicators[human endostatin(ES),rheumatoid factor(RF),erythrocyte deposition rate(ESR)],improvement of clinical symptoms(number of joint swelling,morning stiffness time,joint pain(VAS)score),total response rate and the incidence of adverse reactions(leukopenia,nausea and vomiting,pruritus,and rash)after treatment.Results:Compared with the single group,the combination group had lower IL-17,TH17,TH17/Treg,CRP,TNF-α,IL-1β,IL-1,IgM,IgA,IgG,RF,ESR and joint swelling number,VAS score,higher Treg and ES,and shorter morning stiffness time after treatment.The difference was statistically significant(P<0.05).The total effective rate of combination group(97.50%)was higher than that of single group(80.00%),and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of leukopenia,nausea and vomiting,pruritus and rash between the two groups(P>0.05).Conclusion:In the treatment of RRA,the combination of diacrein and eramod has significant efficacy,which is beneficial to further improve inflammatory factors,immunological indicators and laboratory indicators of patients and alleviate symptoms,and can also correct TH17/Treg imbalance with less a
作者
张雪珍
庄培英
曾艳芳
胡杰峰
ZHANG Xuezhen;ZHUANG Peiying;ZENG Yanfang(Huizhou Central People's Hospital,Guangdong Huizhou 516000,China)
出处
《河北医学》
CAS
2024年第10期1751-1757,共7页
Hebei Medicine
基金
广东省科技计划(医疗卫生)项目,(编号:2020Y101)。
