疾病活动性指标对评估英夫利昔单抗治疗类风湿关节炎早期疗效的作用  

Role of disease activity indexes in assessment of early efficacy of rheumatoid arthritis patients with infliximab treatment

作　　者：林辉[1] 魏翾娣 马玲[1] 周益[1] 周燕莉[2] 张国栋[3] 刘毅[1] 

机构地区：[1]四川大学华西医院风湿免疫科,四川成都610041 [2]四川省乐山市人民医院普通内科,四川乐山614000 [3]泸州医学院风湿科,四川泸州646000

出　　处：《实用临床医药杂志》2014年第5期16-19,共4页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金项目(81102274);成都市科技攻关项目(10GGYB644SF-023);中国高校医学期刊临床专项资金(11321692)

摘　　要：目的探讨疾病活动性指标对评估英夫利昔单抗(IFX)治疗中重度活动性类风湿关节炎(RA)患者早期疗效的作用。方法 14例中重度活动性RA患者初次接受IFX 200 mg滴注,分别于0 h(基线),滴注后3 h、6 h、24 h、3 d、7 d和14 d进行疾病活动性指标评估。主要指标:肿胀关节数目(SJC)、触痛关节数目(TJC)、血清C-反应蛋白(CRP)、血沉(ESR)、疾病活动指数(DAS)28-CRP、健康评估问卷(HAQ)和类风湿因子(RF)。结果 SJC、TJC、CRP、ESR、DAS28-CRP、HAQ及RF等指标均在治疗第14天时明显改善,其中TJC在治疗3 d后开始减少,SJC和HAQ在治疗7 d后改善,CRP和DAS28-CRP于滴注后6 h即开始下降。CRP在3 d时达到低谷,7 d后逐渐回升,14 d时仍低于基线水平。结论 CRP和DAS28-CRP是反映IFX治疗RA早期疗效的最敏感指标,可作为IFX早期疗效的预测因素。Objective To explore the role of disease activity indexes （DAS） in assessment of early efficacy of rheumatoid arthritis （RA） patients with infliximab （IFX） treatment. Methods 14 patients with moderate and severe activity RA were firstly treated with an intravenous infusion of 200 mg IFX. The levels of the swollen joint count （ SJC ）, tender joint count （ TJC ）, C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, DAS28-CRP, the health assessment questionnaire （HAQ） and rheumatoid factor （RF） were evaluated at 0 hour （baseline）, 3,6, 24 hours after infusion and 3, 7 and 14 days after IFX infusion. Results SJC, TJC, CRP, ESR, DAS28-CRP, HAQ and RF improved significantly on 14th day, in which TJC reduced 3 days after treatment, SJC and HAQ improved 7 days after treatment, CRP and DAS28-CRP started to decrease 6 hours immediately after IFX infusion. CRP level was the lowest on third day, and then gradually recovered 7 days after treatment, and remained below the baseline level on 14th day. Conclusion As the most sensitive indexes reflecting the early efficacy of IFX for RA, both CRP and DAS28-CRP can be used as the predictive factors for IFX early efficacy.

关 键 词：类风湿关节炎 英夫利昔单抗 C反应蛋白 疾病活动指数(DAS)28-CRP 

分 类 号：R593.22[医药卫生—内科学]