| 王医林,王 健,刘英纯,吉健华,赵花妮,周子涵,张 倩,朱琳惠.甲氨蝶呤联合来氟米特治疗类风湿性关节炎的疗效及对血清CRP、IL-8及TNF-α水平的影响[J].,2017,17(36):7146-7150 |
| 甲氨蝶呤联合来氟米特治疗类风湿性关节炎的疗效及对血清CRP、IL-8及TNF-α水平的影响 |
| Effects of Methotrexate Combine with Leflunomide on Rheumatoid Arthritis and on Serum Levels of CRP, IL-8 and TNF-α |
| 投稿时间：2017-09-01 修订日期：2017-09-24 |
| DOI：10.13241/j.cnki.pmb.2017.36.034 |
| 中文关键词: 类风湿性关节炎 甲氨蝶呤 来氟米特 C反应蛋白 白细胞介素-8 肿瘤坏死因子-α 临床疗效 |
| 英文关键词: Rheumatoid arthritis Methotrexate Leflunomide C-reactive protein Interleukin-8 Tumor necrosis factor-α Efficacy |
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| 中文摘要: |
| 摘要 目的：探讨甲氨蝶呤联合来氟米特治疗类风湿性关节炎（RA）的疗效及对患者血清C反应蛋白（CRP）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）水平的影响。方法：选择2015年1月至2017年3月我院收治的RA患者106例，采用随机数字表法分为观察组（53例）和对照组（53例），两组均给予常规治疗，对照组加用甲氨蝶呤治疗，观察组在对照组的基础上加用来氟米特治疗，治疗4个月后，评价两组患者的临床疗效、临床症状，并对比两组患者血清CRP、IL-8及TNF-α水平变化。结果：治疗4个月后，观察组临床总有效率为96.23%（51/53），高于对照组的79.25%（42/53），差异有统计学意义（P＜0.05）。治疗前两组晨僵时间、压痛关节数、肿胀关节数等主要临床症状比较差异无统计学意义（P＞0.05）；治疗4个月后，两组晨僵时间较治疗前缩短，压痛及肿胀关节数减少，且观察组晨僵时间短于对照组，压痛及肿胀关节数少于对照组（P＜0.05）。治疗前两组患者血清CRP、IL-8及TNF-α水平比较差异无统计学意义（P＞0.05）；治疗4个月后，两组血清CRP、IL-8及TNF-α水平均较治疗前降低，且观察组低于对照组（P＜0.05）。治疗期间，观察组药物相关不良反应发生率为13.21%（7/53），与对照组的11.32%（6/53）比较，差异无统计学意义（P＞0.05）。结论：甲氨蝶呤联合来氟米特治疗RA的疗效理想，可显著改善患者的临床症状及降低血清CRP、IL-8及TNF-α水平。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the efficacy of methotrexate combine with leflunomide in the treatment of patients with rheumatoid arthritis (RA) and its effects on serum levels of C reactive protein (CRP), Interleukin -8 (IL-8) and tumor necrosis factor-α(TNF-α). Methods: A total of 106 patients with RA, who were treated in the Fifth Hospital of Xi'an from January 2015 to March 2017, were selected and randomly divided into observation group (53 cases) and control group (53 cases). The two groups were given conventional treatment, the control group was added methotrexate,the observation group was added leflunomide on the basis of the control group's therapy. After 4 months of treatment,the clinical efficacy and clinical symptoms of the two groups were evaluated, the changes of serum CRP, IL-8 and TNF-α levels were compared between the two groups. Results: After 4 months of treatment, the total effective rate[96.23% (51/53)] of the observation group was higher than that[79.25% (42/53)] of the control group, the difference was statistically significant (P<0.05). There were no statistic differences in the morning stiffness time, tenderness joint count and swollen joint count between the two groups before treatment (P>0.05). After 4 months of treatment, the morning stiffness time was shorter than that of before treatment between the two groups, tenderness joint count and swollen joint count was decreased, and the morning stiffness time of the observation group was shorter than that of the control group, the tenderness joint count and swollen joint count were lower than that of the control group (P<0.05). There were no significant differences in serum CRP, IL-8 and TNF-α levels between the two groups before treatment (P>0.05). After 4 months of treatment, the serum levels of CRP, IL-8 and TNF-α in the two groups were lower than those before treatment, and the indexes of the observation group was lower than that of the control group (P<0.05). The incidence of drug-related adverse reactions in the observation group was 13.21% (7/53), when compared with 11.32% (6/53) in the control group, the difference was not statistically significant (P>0.05). Conclusion: Methotrexate combined with leflunomide is effective in the treatment of patients with RA, and can significantly improve the clinical symptoms and reduce the levels of serum CRP, IL-8 and TNF-α. |
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