沙利度胺联合甲氨蝶呤与来氟米特治疗重度类风湿关节炎疗效观察  

Clinical efficacy of the concept that lenalidomide methylamine,leflunomide in the treatment of severe rheumatoid arthritis

作　　者：官晓红[1] 陶黎[1] 刘潇潇[1] 任丽蓉[1] 练颖 胡谦[1] 

机构地区：[1]成都市第一人民医院血液风湿科,四川成都610041

出　　处：《实用医院临床杂志》2013年第2期78-80,共3页Practical Journal of Clinical Medicine

摘　　要：目的观察沙利度胺联合甲氨蝶呤与来氟米特治疗重度类风湿关节炎(rheumatoid arthritis,RA)的临床疗效及安全性。方法 65例RA患者根据性别及年龄相似进行配对,运用随机数字表分为两组,A组35例以甲氨蝶呤+来氟米特治疗,B组30例以沙利度胺+甲氨蝶呤+来氟米特治疗,两组均连续治疗6个月,观察病情活动度指标关节肿胀个数、关节压痛个数、晨僵时间、C反应蛋白(CRP)、血沉(ESR)、类风湿因子(RF)及血红蛋白(HGB)、血管内皮生长因子(Vascular endothelialgrowth factor,VEGF)水平。结果两组患者VEGF、HGB及各项病情活动度指标治疗后均明显改善,除A组HGB外,与治疗前比较差异均有统计学意义(P<0.05);治疗后B组VEGF、HGB及各项病情活动度指标的改善优于A组,差异有统计学意义(P<0.05)。两组患者在治疗期间无明显药物不良反应。结论两种治疗方法对重度RA均有效,在传统治疗药物甲氨蝶呤、来氟米特基础上加用沙利度胺,能显著改善RA患者病情,降低VEGF水平,且不增加毒性,尤其在改善关节外症状贫血方面更具优势。Objective Clinical efficacy and safety of the concept that lenalidomide methylamine, leflunomide in the treatment of severe rheumatoid arthritis. Methods 65 cases of rheumatoid arthritis （RA） patients were randomly divided into two groups ： group A a total of 35 cases （ methylamine ＋ leflunomide） , a total of 30 cases of group B （ methotrexate ＋ leflunomide ＋ thalidomide） , continu- ous treatment for 6 months, disease activity index ：joint The number of swelling,joint tenderness, number, duration of morning stiffness, C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, rheumatoid factor （RF） and vascular endothelial growth factor （VEGF） concentration. Results After treatment ,the two groups of serum endothelin factor was significantly decreased （P 〈 0. 05 ）, disease activity index all were decreased （P 〈 0. 05 ） after treatment, total effective rate was 74.29% , Group B total efficiency of 80% , no significant difference between the groups. Two groups of patients during treatment, no significant adverse drug reactions. Conclusions Both treatment methods are effective for severe RA plus conventional therapy methylamine neopterin, leflunomide on the basis of tha- lidomide ,the more significant effect, toxicity, especially in RA patients with anemia.

关 键 词：类风湿关节炎 沙利度胺 甲氨蝶呤 来氟米特 

分 类 号：R593.22[医药卫生—内科学] R971.1[医药卫生—临床医学]