小剂量来氟米特联合甲氨蝶呤治疗类风湿关节炎的临床分析  

A treatment of active rheumatoid arthritis with low dose of leflunomide combined with methotrexate

作　　者：王军[1] 祖比亚[1] 林德帅[1] 杨俊生[1] 覃学勇[1] 廖明[1] 

机构地区：[1]南方医科大学附属柳州医院/柳铁中心医院肾内科,广西柳州545007

出　　处：《重庆医学》2012年第35期3704-3706,共3页Chongqing medicine

基　　金：广西卫生厅自筹经费课题(Z2010135)

摘　　要：目的观察小剂量来氟米特联合甲氨喋呤治疗类风湿关节炎(RA)的临床疗效。方法将30例RA病例随机分为治疗组和对照组。治疗组采用小剂量来氟米特联合甲氨喋呤,对照组单用甲氨喋呤治疗,7.5～15.0毫克/周。观察12个月,观察指标:主要疗效指标有肿胀、压痛关节数、患者及医师对疾病状况总体评价;次要疗效指标有疼痛视觉模拟评分、晨僵时间、健康评价问卷(HAQ)、C反应蛋白;同时记录美国风湿病学会疗效评价指标(ACR20、50)。结果治疗12个月后,治疗组主要疗效指标、次要疗效指标均优于对照组,差异有统计学意义(P<0.05);达到ACR20标准的病例,治疗组占80%,对照组占69.2%,两者比较差异有统计学意义(P<0.05);达到ACR50标准分别为66.7%、38.5%,两者比较差异有统计学意义(P<0.05)。治疗组胃肠道反应轻微,有2例出现血压升高;对照组有2例出现白细胞减少,2例出现肝酶升高。结论小剂量来氟米特联合甲氨喋呤治疗RA,疗效优于单用甲氨喋呤而且耐受性良好。Objective To determine the efficiency of low dose leflunomide combined with methotrexate in the treatment of active rheumatoid arthritis.Methods 30 patients with active rheumatoid arthritis were ramdomized to two groups： the treatment group and control group.The patients of treatment group and control group then received low dose leflunomide combined with methotrexate and methotrexate（7.5-15.0 mg/week） alone respectively.The patients were all observed for 12 months,and the index includes：the main efficiency endpoint（tender and swollen joint counts,global physician and patients assessments） and the secondary efficiency endpoint（VAS,duration of morning stiffness,HAQ,C-reactive protein）.The ACR20,50 were also recorded.Results After 12 months reatment,both the main efficiency and secondary efficiency index in the treatment group were better than control group（P0.05）;the cases reached ACR20 standard were 80% in treatment group and 69.2% in control group（P0.05）;the cases reached ACR50 were 66.7% and 38.5% respectively（P0.05）.Gastrointestinal reactions in treatment group were slight,with 2 cases of high blood pressure;in control group there were 2 cases of leucopenia and 2 cases of elevated liver enzymes.Conclusion Low dose of leflunomide combined with methotrexate were efficacious for active rheumatoid arthritis treatment compared with treatment with methotrexate alone,and they were well tolerated.

关 键 词：来氟米特 甲氨蝶呤 关节炎 类风湿 生物医学研究 小剂量 

分 类 号：R593.22[医药卫生—内科学]