摘要
目的:分析戈利木单抗联合雷公藤多苷对甲氨蝶呤(MTX)治疗反应不佳活动性类风湿关节炎(RA)的临床效果及安全性。方法:选择MTX治疗反应不佳(MTX治疗超3个月,但应答不足)的活动性RA患者66例,按照随机数字表法分为对照组与试验组各33例,对照组单用雷公藤多苷治疗,试验组加用戈利木单抗治疗,测定两组治疗前后血沉(ESR)、C反应蛋白(CRP)、类风湿因子(RF)水平的变化,记录晨僵时间、关节肿胀数目、关节压痛数目,评定治疗效果,采用视觉模拟评分法(VAS)评定患者关节疼痛程度、患者对疾病总体症状的耐受情况,监测两组不良事件的发生情况。结果:(1)治疗后,两组ESR、CRP、RF均降低,与同组治疗前对比差异有统计学意义(P<0.05),试验组ESR、CRP降低幅度高于对照组(P<0.05);(2)治疗后,两组晨僵时间减少、关节肿胀及压痛数目均减少,与治疗前对比差异有统计学意义(P<0.05),试验组各指标改善幅度均高于对照组(P<0.05);(3)治疗后,两组VAS评分均降低,与治疗前对比差异有统计学意义(P<0.05),试验组降低幅度高于对照组(P<0.05);(4)试验组ACR50、ACR70所占比例均高于对照组(P<0.05);(5)试验组、对照组不良反应发生率对比差异无统计学意义(P>0.05)。结论:戈利木单抗联合雷公藤多苷治疗MTX反应不佳活动性RA疗效肯定,可下调患者ESR、CRP水平,缩短晨僵时间,显著改善患者症状,减轻关节疼痛程度,且安全性高。
Objective： To analyze the clinical effects and safety of golimumab combined with tripterygium glycosides on the rheumatoid arthritis （RA） patients with poor response to methotrexate （MTX）. Methods： 66 RA patients with poor response to MTX （MTX treatment 〉 3 months, but lack of response） were selected and randomly divided into the control group and the test group （33 cases in each group）, the control group received simple tripterygium glycosides, the test group added golimumab, erythrocyte sedimentation rate （ESR）, C reactive protein （CRP） and changes of rheumatoid factor level in the two groups before and after the treatment were meastared, the morning rigidity time, the number of swollen joints and the number of painful joints were recorded, treatment effect were evaluated, visual analogue scale （VAS） was used to assess degree of joint pain of patients and tolerance of patients to general symptoms of disease, occurrence of adverse events in the two groups were monitored during the test. Results： ①after the treatment, ESR, CRP and RF in the two groups were significantly reduced compared with the same group before the treatment （P〈0.05）, decrease of ESR and CRP in the test group were significantly higher than the control group （P〈0.05）; ②after the treatment, the morning rigidity time, the number of swollen joints and the number of painful joints were significantly reduced compare with those before the treatment, （P〈0.05）, improvement range of all indexes in the test group were significantly higher than the control group （P〈0.05）; ③after the treatment, VAS scores of the two groups were significantly decreased, there was a significant difference compared with those before the treatment （P〈0.05）, decrease of file test group was significantly higher than the control group （P〈0.05）; ④proportion of ACR50 and ACR70 in the test group were significantly higher than the control group （P〈0.05）; ⑤there was no significant difference in adverse reaction rate between the test group and the control group （P〉0.05）. Conclusions： Golimumab combined with tripterygium glycosides had good efficiency and safety on file RA patients with poor response to MTX, which could down-regulate the patients＇ ESR and CRP levels, shorten the morning rigidity time, improve patients＇ symptoms greatly, reduce degree of joint pain.
出处
《现代生物医学进展》
CAS
2017年第9期1735-1738,1725,共5页
Progress in Modern Biomedicine
基金
湖北省科技攻关项目(2008ZD033)
