益赛普联合来氟米特治疗强直性脊柱炎的个体化方案探讨  

Etanercept and Leflunomide Ndividualized Programs to Explore for the Treatment of Ankylosing Spondylitis

作　　者：庄宇[1] 吕志芬[1] 陈宇航[1] 王志文[1] 叶石保 谭志明[1] 

机构地区：[1]广东省惠州市中心人民医院,广东惠州516001

出　　处：《哈尔滨医药》2017年第6期511-513,共3页Harbin Medical Journal

基　　金：广东省药学会研究基金资助项目(2015FS16)

摘　　要：目的探索一种科学、经济、有效的强直性脊柱炎(Ankylosing spondylitis,AS)患者应用TNF-α拮抗剂的治疗模式,对TNF-α拮抗剂的应用提供可靠的数据及有益的借鉴。方法收集30例AS患者随机分组作为观察对象,按益赛普高、中、低剂量起始组(75、50、25 mg/周),观察达到BASDAI缓解的所需时间。按各评分标准达到低活动再行益赛普减量观察,监测减量后1月、3月、6月及9月的疗效评定(BASDAI),最后统计分析变化趋势的意义。结果高剂量组的患者达到BASDAI缓解明显高于中低剂量组(P<0.05)。达到低活动后中高量维持治疗组缓解程度差异无统计学意义(P<0.05)。结论中高剂量TNF-α拮抗剂起效快,达到临床缓解后减量维持仍比较容易维持低活动水平。低剂量TNF-α拮抗剂起始治疗及维持减量均难维持病情低活动水平。Objective To explore a scientific,economic and effective treatment of TNF-alpha antagonist in patients with AS,and to provide reliable data for the application of TNF-antagonist.Methods Collect 30 cases of AS were randomly divided into three groups;according to etanercept high medium and low dose group（75/50/25 mg/weeks）,the initial observation of BASDAI remission in required time.According to the standard for evaluation activities to achieve low reduction.The curative effect evaluation（BASDAI）in 1 month later,3、6 and 9 months later after the reduction was monitored,and the significance of the change trend was statistically analyzed in the last part of the paper.Results Patients in the high dose group had significantly higher BASDAI remission than the low/medium dose group（P〈0.05）.There was no significant difference between the high dose group and the medium dose group（P〈0.05）after the low activity.Conclusion The middle and high dose of TNF-alpha antagonist has a rapid onset,and it is still easy to maintain low activity level after clinical remission.It is difficult to maintain the low level of activity in the treatment of low dose TNF-alpha antagonist.

关 键 词：强直性脊柱炎 治疗 肿瘤坏死因子-Α拮抗剂 益赛普 来氟米特 

分 类 号：R684[医药卫生—骨科学]