| 王彦焱,凌 彬,古丽仙·艾尔肯,吉 鹏,罗 莉.老年类风湿关节炎患者应用MTX或LEF联合糖皮质激素治疗的效果观察[J].现代生物医学进展英文版,2017,17(15):2903-2906. |
| 老年类风湿关节炎患者应用MTX或LEF联合糖皮质激素治疗的效果观察 |
| Observation on the Effect of MTX or LEF Combined with Glucocorticoid in the Treatment of Elderly Patients with Rheumatoid Arthritis |
| Received:August 19, 2016 Revised:September 20, 2016 |
| DOI：10.13241/j.cnki.pmb.2017.15.026 |
| 中文关键词: 类风湿关节炎 泼尼松 甲氨蝶呤 来氟米特 |
| 英文关键词: Rheumatoid arthritis Prednisone Methotrexate Leflunomide |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2014211C078） |
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| 中文摘要: |
| 摘要 目的：探讨甲氨蝶呤（MTX）或来氟米特（LEF）联合泼尼松（PDN）对老年类风湿关节炎的疗效。方法：选取112例老年RA患者，按随机数表法将患者分为LEF组（n=28）、MTX组（n=28）、LET+PDN组（n=28）、MTX+PDN组（n=28），治疗3个月后统计四组关节肿胀数、关节压痛数、DAS28评分、VAS评分、RF、晨僵时间，并记录不良反应事件。结果：MTX组和LEF组治疗后各项指标均低于治疗前（P<0.05）；MTX+PDN组与LEF+PDN组治疗后各项指标均明显低于治疗前（P<0.001）；MTX+PDN组治疗效果明显优于MTX组（P<0.001）；LEF+PDN组治疗效果明显优于LEF组（P<0.001）；MTX+PDN组治疗总有效率为53.57%，高于LEF+PDN组的42.86%，但差异无统计学意义（x2=2.426，P=0.119）。结论：四组对RA均有治疗效果，联合使用效果更佳，且服药后无严重不良反应，安全性较高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the curative effect of methotrexate (MTX) or leflunomide (LEF) in combination with pred- nisone (PDN) in the treatment of senile rheumatoid arthritis (RA). Methods: 112 elderly patients with RA in our hospital between May 2013 and November 2015 were selected. All patients were divided into LEF group (n=28), MTX group (n=28), LET+PDN group (n=28), MTX+PDN group (n=28) according to the random number table method. After 3 months of treatment, calculate the swollen joints, joint tenderness, DAS28 score, VAS score, RF, morning stiffness time and record the adverse events. Results: The indexes of MTX group and LEF group after treatment were significantly lower than before treatment (P<0.05). The indexes of MTX+PDN group and LEF+PDN group were also significantly lower after treatment than before treatment, and the difference was statistically significant (P<0.001). MTX+PDN group showed significantly better effect than MTX group (P<0.001), and LEF+PDN group also showed significantly better effect than LEF group (P<0.001). The total effective rate of MTX+PDN group was 53.57%, higher than that of 42.86% in LEF+PDN group, but the difference was not statistically significant(x2=2.426, P=0.119). Conclusion: The four groups all had curative effect, but the combination of two had better effect, and there were no serious adverse reactions after treatment. The efficacy difference between MTX+PDN group and LEF+PDN group was not distinct, so they can be selected according to the actual situation. |
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