类风湿性关节炎患者炎症因子变化及阿托伐他汀的干预作用  

Changes of inflammatory cytokines in patients with rheumatoid arthritis and intervention of atorvastatin

作　　者：俞梅[1] 李晓春[2] 郭航远[3] 房溶娟[1] 王根荣[4] YU Mei LIXiaochun GUO Hangyuan et al(Department of Cardiology, Shaoxing Hospital of Chinese Medicine, Shaoxing 312000, China)

机构地区：[1]浙江省绍兴市中医院心内科,312000 [2]浙江大学医学院附属第二医院干部科 [3]浙江省绍兴市人民医院心内科 [4]浙江省绍兴市中医院风湿免疫科,312000

出　　处：《心电与循环》2017年第3期170-174,共5页Journal of Electrocardiology and Circulation

摘　　要：目的研究类风湿性关节炎(RA)患者炎症因子的变化及阿托伐他汀的干预作用。方法将69例RA患者分为观察1组与观察2组。观察1组与观察2组均服用甲氨蝶呤片0.2mg·kg-1·w-1,强的松10mg/d,稳定剂量的NSAID药物抗风湿治疗。观察1组在此治疗基础上加用阿托伐他汀20mg 1次/d。测定治疗前和治疗3个月后的血脂、疾病活动性评分(DAS28评分)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、脂联素,并与对照组比较。结果观察1组、观察2组TG、TC、LDL-C水平、TC/HDL-C、LDL-C/HDL-C比值、CRP、脂联素、TNF-α均高于对照组,差异均有统计学意义(均P<0.05)。观察1组治疗后HDL-C较治疗前明显升高,LDL-C、TC及TG较治疗前下降,差异均有统计学意义(P<0.01)。观察2组治疗后TC、HDL-C较治疗前升高,TC/HDL-C、LDL-C/HDL-C较治疗前明显下降,差异有统计学意义(P<0.01)。治疗后两组DAS28评分、CRP、TNF-α均较治疗前降低,差异均有统计学意义(均P<0.01),其中观察1组显著低于观察2组(P<0.05)。两组脂联素均较治疗前升高,差异有统计学意义(P<0.01)。结论 RA患者炎症因子变化明显,阿托伐他汀能改善RA疾病活动。Objective To observe the changes of inflammatory cytokines in patients with rheumatoid arthritis（RA） and the effect of atorvastatin therapy on inflammation. Methods 69 patients with RA were randomly divided into group 1（n= 36） and group 2 （n= 33）. All patients received methotrexate （MTX 0.2mg-kg-1-w-1, plus prednisone 10 mg every day ）and stable doses of NSAID therapy. Atorvastatin （20 mg every day） was added on the basis of the above treatment in group 1. Disease activity score, serum lipid, C-creative protein（CRP）, serum tumor necrosis factor-α （TNF-α）, adiponectin were measured before and after 3 months of treatment and compared with that of control group. Results TG,TC, LDL-C, TC/HDL-C,LDL-C/HDL-C, CRP, adiponectin and TNF-α were significantly higher in group 1 and group 2 than in control group（all P〈0.05）. HDL-C increased, LDL-C, TC and TG decreased significantly after treatment in group 1（P〈0.01）. TC and HDL-C increased and TC/HDL-C and LDL-C/HDL-C decreased significantly after treatment in group 2 （P〈0.01）. Disease activity score, CRP and TNF-α decreased significantly after treatment in both treatment groups （all P〈0.01）and more significantly in group 1than in group 2（all P〈0.05）. Adiponectin increased significantly in both groups after treatment （P〈0.01）. Conclusion Inflammatory cytokines change obviously in patients with RA. Atorvastatin may improve RA activity, reduce CRP and TNF- α.

关 键 词：类风湿性关节炎 阿托伐他汀 肿瘤坏死因子Α C反应蛋白 

分 类 号：R593.22[医药卫生—内科学]