依那西普治疗中轴脊柱关节炎停药后复发因素的分析

发布时间：2018-06-26 01:47

本文选题：中轴脊柱关节炎 + 强直性脊柱炎　；参考：《第二军医大学学报》2017年10期

【摘要】：目的分析依那西普(ETN)短期联合非甾类抗炎药(NSAIDs)治疗中轴脊柱关节炎(ax-SpA)停药后的复发率及复发危险因素。方法选取125例NSAIDs治疗效果不佳的ax-SpA患者,给予ETN(50mg/周)12周的持续治疗,同时维持应用原有剂量NSAIDs。记录患者的年龄、性别、病程、骶髂关节炎X线分级、脊柱骨赘形成等基线资料;分析患者第0~48周的病情缓解和复发情况以及Bath强直性脊柱炎病情活动指数(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)、C-反应蛋白(CRP)、红细胞沉降率(ESR)的变化情况,记录不良事件。采用二元logistic回归模型及Cox生存函数模型分析ax-SpA患者ETN停药后复发的危险因素。结果 ETN治疗前28例(22.4%)患者已有骨赘形成,骶髂关节炎X线分级3级者最为多见(58例,46.4%)。经12周ETN治疗后120例(96.0%)患者达到临床缓解,BASDAI、BASFI、CRP及ESR均下降(P0.05)。48周内29例(23.2%)患者复发,临床缓解维持时间平均为(36.8±12.3)周。二元logistic回归模型分析示骨赘形成是ax-SpA患者停用ETN后复发的危险因素(OR=70,P0.001)。Cox生存分析结果示骶髂关节炎X线分级越高,维持缓解期越短,且骨赘形成可能是影响维持缓解的重要因素(OR=8.77,P=0.006)。结论对NSAIDs治疗效果不佳的ax-SpA患者,短期足量ETN联合NSAIDs治疗有效。骶髂关节破坏的严重程度及脊柱椎体骨赘形成是引起复发的危险因素。
[Abstract]:Objective to analyze the recurrence rate and risk factors of Einacetin (ETN) combined with nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of axisepheoarthritis (ax-spa). Methods 125 patients with ax-spa who were not well treated with NSAIDs were treated with continuous treatment for 12 weeks (50mg/ week), and the original dose of NSAIDs was maintained. The age, sex, course of disease, X-ray grade of sacroiliac arthritis and osteophyte formation of spine were recorded. The state of remission and relapse of patients with ankylosing spondylitis and the changes of Bath ankylosing spondylitis activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were analyzed and the adverse events were recorded. Binary logistic regression model and Cox survival function model were used to analyze the risk factors of recurrence in patients with ax-spa. Results osteophyte was found in 28 patients (22.4%) before ETN treatment, and the most common was the third grade of sacroiliac arthritis (58 cases, 46.4%). After 12 weeks of ETN treatment, 120 patients (96.0%) achieved clinical remission, both CRP and ESR decreased (P0.05). Within 48 weeks, 29 patients (23.2%) recurred, and the mean duration of clinical remission was (36.8 卤12.3) weeks. Binary logistic regression analysis showed that osteophyte formation was a risk factor for recurrence after ax-spa (OR-70V P0.001). Cox survival analysis showed that the higher the X-ray grade of sacroiliac arthritis was, the shorter the duration of maintenance and remission was, and the formation of osteophyte might be an important factor affecting the maintenance of remission (OR-8.7? 7G P0.006). Conclusion the short term and sufficient ETN combined with NSAIDs is effective in the treatment of ax-spa patients with poor NSAIDs. The severity of sacroiliac joint destruction and the formation of vertebral osteophyte are risk factors for recurrence.
【作者单位】：第二军医大学长海医院风湿免疫科;
【基金】：中华医学会风湿病学学会燎原计划(LYJH-201)~~
【分类号】：R593.23

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