| 王宇 马晶 赵彦萍 梅轶芳 张志毅.长期应用小剂量激素对类风湿关节炎患者的临床疗效及安全性研究[J].,2014,14(32):6281-6283 |
| 长期应用小剂量激素对类风湿关节炎患者的临床疗效及安全性研究 |
| Study on Clinical Efficacy and Safety of Rheumatoid Patients with Long-termUse of Low-dose Glucocorticoids |
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| DOI： |
| 中文关键词: 小剂量 糖皮质激素 类风湿关节炎 临床疗效 安全性 |
| 英文关键词: Low dose Glucocorticoids Rheumatoid arthritis Clinical effect Safety |
| 基金项目: |
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| 中文摘要: |
| 目的：分析长期使用小剂量激素治疗类风湿关节(RA)炎的临床效果及安全性，并探讨小剂量激素的使用方法。方法：将49
例RA 患者随机分为两组，治疗组使用改变病情抗风湿药物(DMARD)及激素泼尼松7.5 mg/d，对照组给予DMARDs。观察和比较
两组患者在不同治疗时间的临床缓解情况及不良反应的发生率。结果：最终49 例患者完成实验(治疗组22 例，对照组27 例)。治
疗第12 周时，治疗组的DAS28 评分显著低于对照组，差异有统计学意义(P<0.05)；治疗24、48 周时，两组的DAS28 评分比较均无
统计学差异(P>0.05)。在治疗第12 周时，治疗组的ACR20 达标率显著高于对照组(P<0.05)；在治疗第24、48 周时，两组的的
ACR20达标率相比无统计学差异(P>0.05)。治疗12、24 周时，两组体重增加的发生率比较无统计学差异(P>0.05)。但在治疗48 周
时，治疗组体重增加的发生率显著高于对照组(P<0.05)；两组胃肠不适及血压升高的发生率相近，且均未发现血糖升高的患者。结
论：与单纯使用DMARDs相比，长期(大于24 周)应用小剂量激素对RA 患者临床症状的缓解作用不明显，但安全性尚可。 |
| 英文摘要: |
| Objective:To analyze the clinical effects and safety of low dose of glucocorticoids (GCs) on patients with rheumatoid
arthritis (RA), and to discuss the application method of GCs.Methods:49 Patients with RA were randomly assigned in a double-blinded
manner to receive GCs (prednisone 7.5 mg/d) or placebo while starting concomitanmt DMARD therapy. The degree of releasation and
incidence of adverse reactions were compared between two groups at different time points.Results:49 patients completed the study(22
patients were treated with GC and DMARDs, while 27 cases were treated with DMARDs alone). At the 12th week, the DAS28 score of
treatment group was lower than that of control group (P＜0.05). At the 24th and 48th week, no statistical difference was found in the
DAS28 score between two groups (P＞0.05). At the 12th week, the qualified rate of ACR20 of treatment group was significantly higher
than that of control group (P＜0.05), however, at the 24th and 48th week, no statistical difference was found between two groups (P＞
0.05). At the 12th and 24th week, there was no statistical difference in the incidence rate of weight gain between two groups (P＞0.05).
However, it was significantly higher in the treatment group than that of control group at the 48th week (P＜0.05). The incidence rates of
rising blood pressure and gastrointestinal discomfort of two groups were equal, and no patients with elevated blood sugar was found.Conclusion:Compared with treatment by DMARDs alone, the clinical advantage of long-term(longer than 24 weeks) use of GCs was not
obvious for the patients with RA. |
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