英夫利西单抗联合甲氨蝶呤治疗类风湿关节炎的疗效观察  

Clinical observation of rheumatoid arthritis treated with infliximab combined with MTX

作　　者：邓梅[1] 韩志伟[1] 马大卫[2] 

机构地区：[1]内江市第一人民医院风湿科,四川内江641000 [2]内江市第一人民医院药剂科,四川内江641000

出　　处：《泸州医学院学报》2013年第2期157-160,共4页Journal of Luzhou Medical College

摘　　要：目的:比较英夫利西单抗(infliximab,IFX)联合甲氨蝶呤(methotrexate,MTX)与来氟米特(LEF)及甲氨蝶呤(MTX)治疗类风湿关节炎(rheumatoid arthritis,RA)的疗效和不良反应。方法:将54例类风湿关节炎患者按随机数字表法分为两组:治疗组31例,治疗组在每周口服甲氨蝶呤(MTX)10～15 mg基础上联合应用英夫利西单抗,在第0、2、6周接受3mg/kg的英夫利西单抗静脉滴注;对照组23例口服相同剂量的MTX,联合应用LEF。疗程均为12周,观察评价关节肿胀压痛数,疼痛视觉模拟评分(Visual Analogue Scale/Score,简称VAS)及疲乏VAS评分,同时监测患者血沉(ESR)、类风湿因子(RF)、肝肾功、血尿常规等指标。结果:在疗程第6周和12周,治疗组患者关节肿胀压痛数、患者VAS评分及血沉改善与对照组比较,差异有统计学意义;DAS28评分比较发现,治疗组患者达到低疾病活动度比例高于对照组,差异有统计学意义(P<0.05)。结论:英夫利西单抗联合甲氨蝶呤治疗类风湿关节炎疗效优于来氟米特与甲氨蝶呤两药联合。Objective： To compare the efficacy and safety between infliximab （IFX） combined with methotrexate （MTX） and leflunomide combined with MTX on the treatment of rheumatoid arthritis. Methods： 54 cases of RA in two groups were retrospectively analyzed. In infliximab treatment group, 31 patients were treated with infliximab 3mg/kg on the 0, 2 and 6 week, combined with methotrexate （MTX）10-15 mg per week. In the comparison group, 23 patients received the same dosage of MTX combined with leflunomide （LEF）. The treatment course was 12 weeks. The indexes of efficacy assessment included the counts of joint tenderness,and joint swollen, patients＇ full-scale assessment with visual analogue scale,and erythrocyte sedimentation rate （ESR）;at the same time adverse events were registered. Results： After 6 and 12 weeks＇ treatment,there were significant differences （P〈0.05）between the two groups,and more patients in the experiment group ameliorated. DAS28 sug gested that the efficacy in the experiment group was better than that in the comparison one. No significant difference was found in adverse events between the two groups. Conclusion： The therapeutic efficacy of MTX combined with infliximab（IFX） on the treatment of rheumatoid arthritis is much better than that of LEF combined with MTX.

关 键 词：英夫利西单抗 来氟米特 甲氨蝶呤 类风湿关节炎 

分 类 号：R593.22[医药卫生—内科学]