甲氨蝶呤联合来氟米特对类风湿关节炎患者炎症因子和免疫球蛋白的影响  

Effect of Methotrexate Combined with Leflunomide on Inflammatory Factors and Immunoglobulin in Patients with Rheumatoid Arthritis

作　　者：杨波[1] 杨正国[1] 王霜[1] 徐磊[1] 郑金亮[1] YANG Bo;YANG Zheng-guo;WANG Shuang;XU Lei;ZHENG Jin-liang(Rheumatism Department of Nephrotic Endocrinology,The 148th Hospital of PLA,Zibo,Shandong,255300,China)

机构地区：[1]解放军第148医院肾病内分泌风湿科,山东淄博255300

出　　处：《现代生物医学进展》2018年第18期3463-3466,3528,共5页Progress in Modern Biomedicine

基　　金：山东省科技攻关项目(2015GSF117186)

摘　　要：目的:探讨甲氨蝶呤联合来氟米特对类风湿关节炎(RA)患者炎症因子和免疫球蛋白的影响。方法:选取于2016年6月-2017年10月期间我院收治的92例RA患者,根据乱数表法将患者随机分为对照组(n=46)与研究组(n=46)。对照组给予口服甲氨蝶呤片,研究组则在对照组的基础上联合来氟米特片治疗。两组均治疗3个月。比较两组患者临床疗效、临床症状改善情况,检测两组患者治疗前后炎症因子、免疫球蛋白水平,观察两组患者不良反应发生情况。结果:研究组患者治疗后的临床总有效率为95.65%(44/46),高于对照组患者的78.26%(36/46)(P<0.05)。两组患者治疗后晨僵时间、压痛关节数、肿胀关节数均较治疗前降低,且研究组低于对照组(P<0.05)。两组患者治疗后血细胞沉降率(ESR)、C反应蛋白(CRP)、白介素-8(IL-8)及肿瘤坏死因子(TNF-α)均较治疗前降低,且研究组低于对照组(P<0.05)。两组患者治疗后免疫球蛋白G(Ig G)、免疫球蛋白A(Ig A)、免疫球蛋白M(Ig M)均较治疗前降低,且研究组低于对照组(P<0.05)。两组患者不良反应发生率比较无差异(P>0.05)。结论:甲氨蝶呤联合来氟米特治疗RA患者效果优于单用甲氨蝶呤治疗,可改善患者临床症状,同时降低Ig G、Ig A、Ig M以及炎症因子水平,无严重不良反应发生。Objective：To investigate the effect of methotrexate combined with leflunomide on inflammatory factors and immunoglobulin in patients with rheumatoid arthritis（RA）.Methods：A total of 92 patients with RA,who were treated in the 148 th Hospital of PLA from June 2016 to October 2017,were selected and were randomly divided into control group（n=46） and study group（n=46）.The control group was given oral Methotrexate Tablets,and the study group was treated with Leflunomide Tablets on the basis of the control group＇s therapy.The two groups were treated for 3 months.The clinical efficacy and the improvement of clinical symptoms were compared between the two groups.The inflammatory factors and immunoglobulin of the two groups were tested before and after treatment,and the incidence of adverse reactions in the two groups was observed.Results：The total effective rate [95.65%（44/46）] of the study group after treatment was significantly higher than that[78.26%（36/46）] of the control group（P〈0.05）.The time of morning stiffness,tender joint count,swollen joint count in the two groups after treatment was lower than before treatment,and the study group was lower than the control group（P〈0.05）.After treatment,the blood sedimentation rate（ESR）,C reactive protein（CRP）,interleukin-8（IL-8）and tumor necrosis factor-α（TNF-α） in the two groups were all lower than those before treatment,and the study group was lower than that in the control group（P〈0.05）.After treatment,immunoglobulin G（Ig G）,immunoglobulin A（Ig A） and immunoglobulin M（Ig M） in the two groups were all lower than those before treatment,and the study group was lower than the control group（P〈0.05）.There was no significant difference in the incidence of adverse reactions between the two groups（P〈0.05）.Conclusion：Methotrexate combined with leflunomide in the treatment of RA patients is better than methotrexate alone,it can significantly improve the clinical symptoms and immune function,and

关 键 词：甲氨蝶呤 来氟米特 类风湿关节炎 炎症因子 免疫球蛋白 疗效 

分 类 号：R593.22[医药卫生—内科学]