| 陈曾凤,兰培敏,陈汉玉,陈 勇,冷冬月.雷公藤多苷联合甲氨蝶呤治疗类风湿关节炎活动期患者的疗效及对血清CD62p、CD41的影响[J].,2018,(20):3909-3912 |
| 雷公藤多苷联合甲氨蝶呤治疗类风湿关节炎活动期患者的疗效及对血清CD62p、CD41的影响 |
| Curative Efficacy of Tripterygium Glycosides Combined with Methotrexate in Treatment of Rheumatoid Arthritis Active Stage and Its Effects on Serum CD62p and CD41 Levels |
| 投稿时间：2018-04-25 修订日期：2018-05-18 |
| DOI：10.13241/j.cnki.pmb.2018.20.024 |
| 中文关键词: 类风湿关节炎 活动期 雷公藤多苷 甲氨蝶呤 释放黏附分子 |
| 英文关键词: Rheumatoid arthritis Active stage Tripterygium glycosides Methotrexate Release of adhesion molecules |
| 基金项目:湖北省自然科学基金项目(2009CD13) |
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| 中文摘要: |
| 摘要 目的：探讨雷公藤多苷联合甲氨蝶呤治疗类风湿关节炎（RA）活动期患者的疗效及对血清释放黏附分子CD62p、CD41的影响。方法：选择2015年6月至2017年6月我院接诊的90例类RA活动期患者作为研究对象，通过随机数表法分为观察组（n=45）和对照组（n=45），对照组口服甲氨蝶呤治疗，观察组联合雷公藤多苷片治疗，均连续用药12周。比较两组临床疗效、治疗前后临床症状评分、实验室指标[红细胞沉降率（ESR）、C反应蛋白（CRP）、血小板计数（PLT）]及血清CD62p、CD41的变化，并比较治疗期间不良反应。结果：观察组临床疗效总有效率为91.11%（41/45），明显高于对照组的66.67%（30/45）（P＜0.05）；治疗后，两组临床症状评分及实验室指标较治疗前均显著降低（P＜0.05），观察组晨僵时间、关节疼痛、关节肿胀、关节压痛评分及ESR、CRP、PLT均明显比对照组，比较均具有显著差异（P＜0.05）；治疗后，两组血清CD62p、CD41较治疗前均显著降低（P＜0.05），观察组血清CD62p、CD41均明显低于对照组[（16.58±2.10）%vs（25.46±2.58）%，（67.83±11.03）%vs（76.40±13.45）%]（P＜0.05）；两组治疗期间肝肾功能均未发生异常，两组头痛、皮疹、胃肠道反应、感染、脱发发生率均无显著差异（P＞0.05）。结论：在RA活动期患者中使用雷公藤多苷联合甲氨蝶呤效果显著，可有效改善临床症状及实验室指标，其内在机制可能和降低血清CD62p、CD41的表达相关，且联合用药安全性高，值得应用推广。 |
| 英文摘要: |
| ABSTRACT Objective: To study surative efficacy of tripterygium glycosides combined with methotrexate in treatment of rheumatoid arthritis(RA) active stage and its effects on serum release of adhesion molecules CD62p and CD41 levels. Methods: 90 patients of RA active stage who received therapy from June 2015 to June 2017 in our hospital were selected as research objects. According to random number table, those patients were divided into the observation group (n=45) and the control group (n=45), the control group was treated with oral methotrexate, while the observation group was combined with tripterygium glycosides, they were used for 12 weeks. The clinical efficacy, clinical symptom score, laboratory index[Erythrocyte sedimentation rate (ESR), C reactive protein (CRP), platelet count (PLT)], and serum CD62p and CD41 before and after treatmentof two groups were changed, and the adverse reactions was compared. Results: The total effective rate of clinical efficacy in the observation group was 91.11% (41/45), which was significantly higher than that of the control group 66.67% (30/45)(P＜0.05); after treatment, the clinical symptom scores and laboratory indexes of two groups were significantly lower than those before treatment(P＜0.05), the morning stiffen, joint pain, joint swelling, joint pressure pain and ESR, CRP and PLT in the observation group were significantly lower than that of control group, there are significant differences in comparison (P＜0.05); after treatment, the serum CD62p and CD41 levels in the two groups were significantly lower than those before the treatment(P＜0.05), the serum CD62p and CD41 in the observation group were significantly lower that of the control group[（16.58±2.10）% vs（25.46±2.58）%, （67.83±11.03）%vs（76.40±13.45）%]（P＜0.05）; there was no abnormal liver and kidney function during the treatment of the two groups. there was no significant difference in the incidence of headache, rash, gastrointestinal reaction, infection and alopecia in the two groups(P＞0.05). Conclusion: Tripterygium glycosides combined with methotrexate is well for RA active stage, which can effectively improve clinical symptoms and laboratory indicators, its intrinsic mechanism may be associated with the reduction of the expression of serum CD62p and CD41, and the combination of drug safety is high, its worthy of application and promotion. |
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