艾拉莫德片联合甲氨喋呤片治疗老年类风湿关节炎的临床研究  

Clinical trial iguratimod combined with methotrexate on peripheral blood T lymphocyte and B lymphocyte in the treatment of elderly patients with rheumatoid arthritis

作　　者：孟岩[1] 李明远[1] 罗德梅[1] 张新玉[1] 罗莉[1] MENG Yan LIMing- yuan LUO De - mei ZHANG Xin - yu LUO Li(Department of Rheumatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, Chin)

机构地区：[1]新疆医科大学第一附属医院风湿免疫科,乌鲁木齐830000

出　　处：《中国临床药理学杂志》2017年第12期1098-1101,共4页The Chinese Journal of Clinical Pharmacology

基　　金：新疆医科大学第一附属医院2013年院内科研基金资助项目

摘　　要：目的观察艾拉莫德片联合甲氨喋呤片治疗老年类风湿关节炎(RA)的临床疗效及对患者外周血T淋巴细胞和B淋巴细胞的影响。方法将120例老年类风湿关节炎患者随机分为对照组60例和试验组60例。对照组给予甲氨蝶呤片10 mg,每日1次,口服;试验组在对照组基础上给予艾拉莫德片25 mg,每天2次,口服。2组疗程均为3个月。治疗后,比较2组患者的临床疗效、关节症状改善情况、实验室检查指标变化及外周血T淋巴细胞、B淋巴细胞水平。结果治疗后,试验组总有效率为93.34%(56/60例),对照组为80.00%(48/60例,P<0.05)。治疗后,试验组关节疼痛指数,关节压痛指数,肿胀指数分别为6.85±3.02,4.21±2.13,4.01±1.03,对照组分别为10.16±3.26,7.63±3.16,6.15±1.02,差异均有统计学意义(均P<0.05)。治疗后,试验组和对照组类风湿因子(RF)分别为(9.11±3.02),(15.31±5.24)U·mL^(-1);抗链球菌溶血素O抗体(ASO)分别为(112.26±9.54),(143.15±9.25)U·mL^(-1);C-反应蛋白(CRP)分别为(3.46±0.07)g·L^(-1),(7.40±1.02)g·L^(-1),差异均有统计学意义(均P<0.05)。治疗后,试验组和对照组外周血T淋巴细胞CD3水平分别为(66.77±5.42)%,(63.53±5.21)%;CD4水平为(38.31±5.09)%,(33.52±4.23)%;淋巴细胞分别为(30.71±4.79)%,(38.43±5.24)%;差异均有统计学意义(均P<0.05)。试验组和对照组CD8水平分别为(27.32±4.48)%,(27.54±4.21)%,差异无统计学意义(P>0.05)。试验组主要药物不良反应包括胃肠道反应、白细胞减少和肝功能异常,药物不良反应发生率为21.67%(13/60例),对照组药物不良反应包括胃肠道反应和白细胞减少,药物不良反应发生率为18.33%(11/60例),差异无统计学意义(P>0.05)。结论艾拉莫德联合甲氨喋呤是老年类风湿关节炎的有效治疗方案,能够显著提高临床疗效,改善关节症状和实验室指标,并且能够调节机体免疫功能。Objective To investigate the clinical efficacy of iguratimod combined with methotrexate in elderly patients with rheumatoid arthritis（RA） and its effects on peripheral blood T lymphocyte and B lymphocyte. Methods A total of 120 elderly patients with RA were randomly divided into treatment group and control group,each group 60 cases.Control group was orally given methotrexate 10 mg,qd. Treatment group was orally given iguratimod 25 mg,twice a day on the basis of control group. All patients were treated for 3 months. After treatment, the clinical efficacy, improvement of joint symptoms, changes oflaboratorytests and levels of peripheral blood T lymphocyte,B lymphocyte were compared in two groups. Results The clinical efficacy in treatment group was 93. 34%（56/60）,had significant difference with that in control group,which was 80. 00%（48/60,P〈0. 05）. The joint pain index,joint tenderness index and joint swollenness index were6. 85 ± 3. 02,4. 21 ± 2. 13,4. 01 ± 1. 03 in treatment group,had significant difference with those in control group,which were 10. 16 ± 3. 26,7. 63 ± 3. 16,6. 15 ± 1. 02（P〈0. 05）. After treatment,the levels of rheumatoid factor（RF）,antistreptolyisn O antibody（ASO）,C-reactive protein（CRP） in treatment group were（9. 11 ± 3. 02）U·mL^-1,（112. 26 ± 9. 54） U · mL^-1,（3. 46 ± 0. 07） g · L^-1,had significant difference with those in control group,which were（15. 31 ± 5. 24） U·mL^-1,（143. 15 ± 9. 25） U·mL^-1,（7. 40 ± 1. 02） g·L^-1（P〈0. 05）.The levels of peripheral blood T lymphocyte CD3, CD4 and level of B lymphocyte in treatment group were（66. 77 ± 5. 42） %,（38. 31 ± 5. 09） %,（30. 71 ± 4. 79） %,had significant difference with those in control group,which were（63. 53 ± 5. 21） %,（33. 52 ± 4. 23） %,（38. 43 ± 5. 24） %（P〈0. 05）. While levels of CD8 in treatment and control groups were（27. 32 ± 4. 48） %,（27. 54 ± 4. 21） %（P〈0. 05）. The adverse drug reactions in treatment group wer

关 键 词：艾拉莫德 甲氨蝶呤 类风湿关节炎 T淋巴细胞 B淋巴细胞 

分 类 号：R979.5[医药卫生—药品]