艾拉莫德片联合甲氨喋呤片治疗老年类风湿关节炎的临床研究

发布时间：2018-05-12 07:35

本文选题：艾拉莫德 + 甲氨蝶呤　；参考：《中国临床药理学杂志》2017年12期

【摘要】：目的观察艾拉莫德片联合甲氨喋呤片治疗老年类风湿关节炎(RA)的临床疗效及对患者外周血T淋巴细胞和B淋巴细胞的影响。方法将120例老年类风湿关节炎患者随机分为对照组60例和试验组60例。对照组给予甲氨蝶呤片10 mg,每日1次,口服;试验组在对照组基础上给予艾拉莫德片25 mg,每天2次,口服。2组疗程均为3个月。治疗后,比较2组患者的临床疗效、关节症状改善情况、实验室检查指标变化及外周血T淋巴细胞、B淋巴细胞水平。结果治疗后,试验组总有效率为93.34%(56/60例),对照组为80.00%(48/60例,P0.05)。治疗后,试验组关节疼痛指数,关节压痛指数,肿胀指数分别为6.85±3.02,4.21±2.13,4.01±1.03,对照组分别为10.16±3.26,7.63±3.16,6.15±1.02,差异均有统计学意义(均P0.05)。治疗后,试验组和对照组类风湿因子(RF)分别为(9.11±3.02),(15.31±5.24)U·mL~(-1);抗链球菌溶血素O抗体(ASO)分别为(112.26±9.54),(143.15±9.25)U·mL~(-1);C-反应蛋白(CRP)分别为(3.46±0.07)g·L~(-1),(7.40±1.02)g·L~(-1),差异均有统计学意义(均P0.05)。治疗后,试验组和对照组外周血T淋巴细胞CD3水平分别为(66.77±5.42)%,(63.53±5.21)%;CD4水平为(38.31±5.09)%,(33.52±4.23)%;淋巴细胞分别为(30.71±4.79)%,(38.43±5.24)%;差异均有统计学意义(均P0.05)。试验组和对照组CD8水平分别为(27.32±4.48)%,(27.54±4.21)%,差异无统计学意义(P0.05)。试验组主要药物不良反应包括胃肠道反应、白细胞减少和肝功能异常,药物不良反应发生率为21.67%(13/60例),对照组药物不良反应包括胃肠道反应和白细胞减少,药物不良反应发生率为18.33%(11/60例),差异无统计学意义(P0.05)。结论艾拉莫德联合甲氨喋呤是老年类风湿关节炎的有效治疗方案,能够显著提高临床疗效,改善关节症状和实验室指标,并且能够调节机体免疫功能。
[Abstract]:Objective to observe the clinical effect of Ailamod tablet combined with methotrexate tablet in the treatment of senile rheumatoid arthritis (RA) and its effect on T and B lymphocytes in peripheral blood of patients with rheumatoid arthritis. Methods 120 elderly patients with rheumatoid arthritis were randomly divided into control group (n = 60) and experimental group (n = 60). The control group was given 10 mg methotrexate once a day, and the experimental group was given 25 mg of Elamod tablet on the basis of the control group, twice a day for 3 months. After treatment, the clinical efficacy, the improvement of joint symptoms, the changes of laboratory parameters and the level of T lymphocyte B lymphocytes in peripheral blood were compared between the two groups. Results after treatment, the total effective rate of the trial group was 93.34 / 56 / 60 cases, and that of the control group was 80.00% / 48 / 60 cases (P 0.05). After treatment, the joint pain index, joint tenderness index and swelling index were 6.85 卤3.02 卤4.21 卤2.13 卤4.01 卤1.03 in the experimental group and 10.16 卤3.267.63 卤3.16 卤6.15 卤1.02 in the control group, respectively (P 0.05). After treatment, the RFFs of rheumatoid factors in the experimental group and the control group were 15.31 卤5.24 U / mL and 143.15 卤9.25 U mL / L ~ (-1), respectively, and there were significant differences (P < 0.05) between the experimental group and the control group (P < 0. 05), and those of the experimental group and the control group were 15. 11 卤3. 02 卤5. 24 U / L and 14. 26 卤9. 54 U / L respectively (P < 0. 05), respectively. After treatment, the levels of CD3 of peripheral blood T lymphocytes in the test group and the control group were 66.77 卤5.42 and 63.53 卤5.21, respectively. The levels of CD4 were 38.31 卤5.09 and 33.52 卤4.23 respectively, and the lymphocyte levels were 30.71 卤4.79 and 38.43 卤5.24, respectively, and the difference was statistically significant (P 0.05). The CD8 levels in the test group and the control group were 27.32 卤4.48 and 27.54 卤4.21, respectively. There was no significant difference between the two groups (P 0.05). The main adverse drug reactions in the trial group included gastrointestinal reactions, leukopenia and liver dysfunction. The incidence of adverse drug reactions was 21.67 / 1360 cases, while the control group included gastrointestinal reactions and leukopenia. The incidence of adverse drug reactions was 18.33 / 11 / 60 with no significant difference (P 0.05). Conclusion Elamod combined with methotrexate is an effective treatment for rheumatoid arthritis in the elderly. It can significantly improve the clinical efficacy, improve the joint symptoms and laboratory indicators, and regulate the immune function of the body.
【作者单位】：新疆医科大学第一附属医院风湿免疫科;
【基金】：新疆医科大学第一附属医院2013年院内科研基金资助项目
【分类号】：R593.22

【相似文献】