[1]刘昌莲,贺冬冬,李晓明,等.艾拉莫德治疗类风湿关节炎疗效及对患者免疫炎症因子水平和骨代谢指标的影响*[J].陕西医学杂志,2020,49(5):603-607.
　LIU Changlian,HE Dongdong,LI Xiaoming,et al.Clinical efficacy of Iguratimod in the treatment of rheumatoid arthritis and its effect on the levels of immune inflammatory factors and the indexes of bone metabolism[J].,2020,49(5):603-607.
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艾拉莫德治疗类风湿关节炎疗效及对患者免疫炎症因子水平和骨代谢指标的影响*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年5期
页码:
603-607
栏目:
药物与临床
出版日期:
2020-05-05

文章信息/Info

Title:
Clinical efficacy of Iguratimod in the treatment of rheumatoid arthritis and its effect on the levels of immune inflammatory factors and the indexes of bone metabolism
文章编号:
DOI:10.3969/j.issn.10007377.2020.05.025
作者:
刘昌莲; 贺冬冬; 李晓明; 王丽娜△
西安市第五医院风湿免疫科(西安710082)
Author(s):
LIU Changlian; HE Dongdong; LI Xiaoming; et al.
Department of Rheumatology and Immunology,the Fifth Hospital of Xi'an(Xi'an 710082)
关键词:
类风湿关节炎;  治疗;  艾拉莫德;  免疫抑制;  骨代谢;  疗效
Keywords:
Rheumatoid arthritis;  Therapy;  Iguratimod;  Immunosuppression;  Bone metabolism;  Curative effect
分类号:
R593.22
文献标志码:
A
摘要:
目的:探讨艾拉莫德治疗类风湿关节炎临床疗效及对患者免疫炎症因子水平和骨代谢指标的影响。方法:146例类风湿关节炎患者,随机数字法均分为对照组与试验组,对照组给予甲氨蝶呤联合羟氯喹治疗,试验组给予甲氨蝶呤联合艾拉莫德口服治疗,两组患者连续治疗6个月。比较两组患者治疗6个月后的临床疗效、治疗前后炎症免疫因子水平变化,对骨代谢的影响以及不良反应发生情况。结果:治疗后6个月,试验组总有效率97.26%显著高于对照组的90.41%,其中试验组无效2例显著低于对照组的7例(P<0.05); 试验组炎症因子环氧合酶(COX-2)(12.42±2.87)pg/ml、肿瘤坏死因子α(TNF-α)(4.38±1.12)μg/L、集落刺激因子(M-CSF)(823±162)pg/ml和白细胞介素6(IL-6)(24.29±3.51)pg/ml均显著低于对照组,免疫因子CD4+(35.46±6.02)%、CD4+/CD8+(1.85±0.46)%、IgA(2.85±0.87)g/L、IgM(1.95±0.88)g/L均显著高于对照组(P<0.05); 治疗6个月后试验组压痛关节数(TJC)、指关节肿胀数(SJC)、类风湿关节炎患者病情评估(DAS28评分)、晨僵、血沉(ESR)、C反应蛋白(CRP)以及类风湿因子(RF)指标均显著低于对照组(P<0.05); 试验组骨代谢指标骨钙素N端中分子片段(20.04±4.01)ng/ml、总I型胶原氨基端延长肽(45.46±6.97)ng/ml和25羟维生素D(19.21±4.55)ng/ml水平均明显高于对照组,β-胶原降解产物(0.42±0.15)pg/ml水平明显低于对照组(P<0.05); 治疗后6个月,试验组不良反应总发生率8.22%与对照组总发生率的10.96%,组间比较差异无统计学意义(P>0.05)。结论:艾拉莫德治疗类风湿关节炎疗效显著,可改善患者临床症状及关节受累情况,提高免疫力,且不良反应发生率低。
Abstract:
Objective:To investigate the clinical efficacy of Iguratimod in the treatment of rheumatoid arthritis and its effect on the levels of immune inflammatory factors and the indexes of bone metabolism. Methods:146 patients with rheumatoid arthritis were randomly divided into the control group and the experimental group. The control group was treated with methotrexate combined with hydroxychloroquine,and the experimental group was treated with methotrexate combined with Iguratimod orally. The two groups were treated continuously for 6 months. The clinical efficacy of the two groups after 6 months of treatment,the changes of inflammatory immune factors before and after treatment,the effects on bone metabolism and the occurrence of adverse reactions were compared between the two groups. Results:After 6 months of treatment,the total effective rate of the experimental group(97.26%)was significantly higher than that of the control group(90.41%),and the number of invalid cases in the experimental group(2 cases)were significantly lower than that in the control group(7 cases)(P<0.05). COX-2 [(12.42±2.87)pg/ml],TNF-α [(4.38±1.12)pg/L],M-CSF[(823±162)pg/ml]and IL-6 [(24.29±3.51)pg/ml] were significantly lower in the experimental group than those in the control group,while CD4+ [(35.46±6.02)%],CD4+/CD8+[(1.85±0.46)%],IgA [(2.85±0.87)g/L] and IgM [(1.95±0.88)g/L] were significantly higher than those in the control group(P<0.05). After 6 months of treatment,TJC,SJC,DAS28 scores,morning stiffness,ESR,CRP and RF indexes in the experimental group were significantly lower than those in the control group(P<0.05). N-MID [(19.75±3.78)ng/ml],T-P1NP[(45.46±6.97)ng/ml] and 25(OH)D [(19.21±4.55)ng/ml] in the experimental group were significantly higher than those in the control group,while β-CTX [(0.42±0.15)pg/ml] was significantly lower than that in the control group(P<0.05). After 6 months of treatment,the total incidence of adverse reactions was 8.22% in the experimental group and 10.96% in the control group,with no significant difference between the groups(P>0.05). Conclusion:Iguratimod is effective in treating rheumatoid arthritis,can improve clinical symptoms and joint involvement,improve immunity,and the incidence of adverse reactions is low.

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备注/Memo

备注/Memo:
*陕西省卫生科研基金扶持项目(2012D78)
更新日期/Last Update: 2020-07-28