小剂量泼尼松联合甲氨蝶呤对类风湿关节炎炎性细胞因子的影响  

Effects of low dose prednisone combined with methotrexate on inflammatory cellular factors in rheumatoid arthritis

作　　者：江珂[1] 冯士广 路娜[3] 蔡金生[1] 陈攀晓 

机构地区：[1]冀中能源邢台矿业集团有限责任公司总医院,河北邢台054000 [2]河北省邢台市巨鹿县医院,054000 [3]河北省邢台市人民医院,054000

出　　处：《检验医学与临床》2017年第11期1553-1555,共3页Laboratory Medicine and Clinic

摘　　要：目的观察小剂量泼尼松联合甲氨蝶呤在类风湿关节炎患者中的临床治疗效果及对外周血炎性细胞因子的影响。方法选取类风湿关节炎患者220例,随机分为对照组(110例)和观察组(110例)。对照组采用甲氨蝶呤联合叶酸治疗,观察组采用甲氨蝶呤、叶酸和泼尼松治疗,采用酶联免疫吸附试验测定两组患者治疗前、后C反应蛋白(CRP)、白细胞介素-32(IL-32)和基质金属蛋白酶-13(MMP-13)水平,比较两组患者临床疗效及对外周血炎性细胞因子的影响。结果两组患者治疗前晨僵、关节压痛数、关节肿胀数比较差异无统计学意义(P>0.05);观察组治疗后6个月晨僵、关节压痛数、关节肿胀数低于对照组(P<0.05);两组治疗前视觉模拟评分(VAS评分)、风湿性关节炎活动度评分(DAS评分)及红细胞沉降率(ESR)差异无统计学意义(P>0.05);观察组治疗后6个月VAS评分、DAS评分及ESR低于对照组(P<0.05);两组治疗前CRP、IL-32和MMP-13水平比较差异无统计学意义(P>0.05);观察组治疗后CRP、IL-32和MMP-13水平低于对照组(P<0.05);观察组治疗6个月后并发症发生率与对照组相比差异无统计学意义(P>0.05)。结论类风湿关节炎患者采用小剂量泼尼松联合甲氨蝶呤治疗效果理想,值得推广应用。Objective To observe the clinical curative effect of low-dose prednisone combined with methotrexate in the patients with rheumatoid arthritis and its influence on peripheral blood inflammatory cytokines. Methods Two hundreds and twenty patients with rheumatoid arthritis were randomly divided into the control group （n= 110） and the observation group （n= 110）. Methotrexate combined with folic acid was used in the control group. Methotrexate, folic acid and prednisone were used in the observation group. C-reactive protein （CRP） and interleukin （IL） were measured before and after treatment by enzyme-linked immunosorbent assay（ELISA）. The levels of interleukin-32（IL-32） and matrix metalloproteinase-13 （MMP-13） were measured by immunohisto- chemistry. The clinical effects and influences on inflammatory cytokines in peripheral blood were compared between the two groups. Results There was no statistically significant difference in morning stiffness,joint tenderness and joint swelling before treatment between the two groups （P〉0.05）. The number of morning stiffness,joint tenderness and joint swelling after 6-month treatment in the observation group were lower than those in the control group（P〈0.05） ; the visual analogue scale （VAS） score, rheumatoid arthritis activity score （DAS score） and erythrocyte sedimentation rate （ESR） before treatment had no statistically significant difference between the two groups （P〉0.05）. The VAS score,DAS score and ESR after 6-month treatment in the observation group were lower than those in the control group; the levels of CRP,IL-32 and MMP-13 before treatment had no statistical difference between the two groups（P〉0.05）; the levels of CRP,IL-32 and MMP-13 after treatment in the observation group were lower than those in the control group（P〈0.05） ; the occurrence rate of complications after 6-month treatment had no statistical difference between the observation group and control group （P〉0.05）. Conclusion Low dose pr

关 键 词：类风湿关节炎 泼尼松 甲氨蝶呤 炎性细胞因子 

分 类 号：R541.6[医药卫生—心血管疾病]