甲氨蝶呤联合益赛普治疗类风湿风湿关节炎  

Methotrexate and Etanercept Treatment of Rheumatoid Arthritics

作　　者：赵颖[1] 苑晓娟[1] 孟力平[1] 

机构地区：[1]大同市第五人民医院风湿免疫科,山西大同037006

出　　处：《山西大同大学学报（自然科学版）》2014年第3期52-54,共3页Journal of Shanxi Datong University(Natural Science Edition)

摘　　要：目的评价甲氨蝶呤联合益赛普治疗类风湿关节炎（RA）临床疗效以及安全性.方法随机将90例类风湿关节炎患者分为2组：联合治疗组45例,口服甲氨蝶呤10～15 mg 1次/周,益赛普50 mg 1次/周,皮下注射;对照组45例单用甲氨蝶呤10～15mg 1次/周.疗程为3月,对2组的临床症状及实验室指标改善情况进行评价.结果2组的临床症状即关节疼痛数、关节肿胀数的改善均有良好效果,联合治疗组优于对照组;2组治疗后血沉（ESR）、C反应蛋白（CRP）均明显降低,且联合治疗组优于对照组.安全性方面,联合用药组一例出现肺部感染,停药及给予消炎药后好转.1例最初出现注射局部皮肤红肿伴瘙痒,3d后自行消失,未影响患者正常用药.对照组1例于服用甲氨蝶呤第2日出现头晕及胃肠道不适,1例出现口腔溃疡,1例化验血常规白细胞降低.结论甲氨蝶呤联合益赛普治疗类风湿关节炎疗效肯定,不良反应少,且明显较单用甲氨蝶呤组效果好.Objective To evaluate the efficacy and safety of metbotrexate （MTX） combined with etanercept in the treatment of rheumatoid arthritics（RA）. Methods We randomly selected 90 cases of rheumatoid arthritics patients who were in our hospital from August 2011 to December 2011.Then they were divided into two groups ：45 cases in the methotrexate （MTX） combined with etanercept were treated by methotrexate （MTX） 10-15mg once a week.And by hypodermic injection ,once a week. Nevertheless, 45 cases in the metho- trexate （MTX） alone group were treated by methotrexate （MTX） 10-15mg once a week .The treatment procedure was 3 months. What is more,the clinical symptoms and the improving situation of laboratory parameters were observed for evaluation. Results The consequence of clinical symptoms was so good, namely the times of joint pain,the improvement of the number of joint swelling had been decreased a lot. So the combined treatment group was better than the single control group. In additional, after the treatment, erythrocyte sedimentation rate（ESA）,C-reactive protein（CRP） were significantly decreased. In this way, the single control group was worse than combined treatment group. Security ： There was one patient in combined group had lung infections, and improved after withdrawal and anti-inflammatory drugs. And one case originally appeared injection of local skin irritation with itching, disappeared without influencing the normal treatment after 3 days.In single control group ,there were 2 symptoms. One case who had taken methotrexate appeared dizziness and gastrointestinal discomfort, one case had dental ulcers. After conventional blood test, one case had a few less leukocytes than general. Conclusions The efficacy of methotrexate（MTX） combined with etanercept is good. It（methotrexate（MTX） combined with etanercept） has fewer adverse reactions, and it is better than methotrexate alone group.

关 键 词：甲氨蝶呤 益赛普 类风湿关节炎 

分 类 号：R593.22[医药卫生—内科学]