重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白、来氟米特联合超短波治疗RA的临床疗效  

Clinical Effect of Recombinant Human Type Ⅱ Tumor Necrosis Factor Receptor Antibody Fusion Protein,Leflunomide Combined with Ultrashort Wave Therapy for the Treatment of RA Patients

作　　者：徐建萍[1] 郭粉娥[2] 岳晓琳[1] 王佩[1] 周红敏 李俊芳[1] 王卫远[1] 刘曦[1] XU Jianping;GUO Fen′e;YUE Xiaolin;WANG Pei;ZHOU Hongmin;LI Junfang;WANG Weiyuan;LIU Xi(Department of Immunization;Department of Rehabilitation,Handan Central Hospital,Handan 056001,China)

机构地区：[1]邯郸市中心医院免疫科,河北邯郸056001 [2]邯郸市中心医院康复医学科,河北邯郸056001

出　　处：《医学综述》2018年第21期4346-4349,共4页Medical Recapitulate

基　　金：河北省卫生计生委科技计划项目(20181695)

摘　　要：目的分析重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白(rh TNFR:Fc)、来氟米特联合超短波治疗类风湿关节炎(RA)的临床疗效。方法选择2016年2—12月邯郸市中心医院诊治150例RA患者为研究对象,按照随机数字法分为对照组和观察组,各75例。对照组给予rh TNFR:Fc每次25 mg,皮下注射,2次/周,来氟米特每次20 mg,每日1次,口服;观察组在对照组基础上联合超短波治疗。分别评估两组患者治疗后6周、12周的临床疗效,治疗前、治疗后6周、12周的28个关节的疾病活动度评分(DAS28评分)、晨僵时间、休息痛;并检测患者红细胞沉降率(ESR)、类风湿因子(RF)、C反应蛋白(CRP)、抗环瓜氨酸肽抗体(抗CCP抗体)水平。结果治疗后12周,观察组治疗总有效率高于对照组[98. 67%(74/75)比90. 67%(68/75)](P <0. 05)。两组治疗后6周、治疗后12周DAS28评分、晨僵时间和休息痛评分、ESR、RF、CRP和抗CCP抗体水平均较治疗前呈下降趋势,且观察组下降速度更快,两组在组间、时点间、组间·时点间交互作用比较差异有统计学意义(P <0. 05)。结论应用rh TNFR:Fc、来氟米特联合超短波治疗RA患者,临床疗效显著,并能显著改善关节功能,降低血ESR、RF、CRP和抗CCP抗体水平,并随治疗时间的延长,效果更佳。Objective To analyze the application of recombinant human type Ⅱ tumor necrosis factor receptor antibody fusion protein（rhTNFR：Fc）,leflunomide combined with ultrashort wave therapy in the treatment of rheumatoid arthritis（RA）. Methods A total of 150 patients with RA treated in Handan Central Hospital from Feb. 2016 to Dec. 2016 were selected and divided into a control group and an observation group,according to the random number method,with 75 cases in each group.The control group was given rhTNFR：Fc 25 mg/time, subcutaneous injection,2 times/week, leflunomide 20 mg /time,1 time/d, oral. The observation group was given ultrashort wave therapy on the basis of the control group′s regimen.The rest pain, morning stiffness, and 28 joint disease activity scores（DAS28） were assessed before treatment and after 6 and 12 weeks of treatment.And erythrocyte sedimentation rate（ESR）,rheumatoid factor（RF）,C-reactive protein（CRP）,anti-cyclic citrate peptide（CCP） antibody levels were measured. Results The total effective rate of the observation group after 12 weeks of treatment was higher than that of the control group[98.67%（74/75） vs 90.67%（68/75）, P 〈0.05 ]. DAS28 scores, morning stiffness and rest pain scores,ESR, RF, CRP and anti-CCP antibody levels were all decreased after 6 and 12 weeks of treatment,and the observation group decreased faster,and the differences between groups,time points,group·time point interaction were statistically significant（ P 〈0.05）. Conclusion The clinical effect of rhTNFR ：Fc, leflunomide combined with ultroshort wave therapy for RA patients is better and can significantly improve the joint function,lower blood ESR,RF,CRP and anti-CCP antibody levels,which gets better with extension of the treatment time.

关 键 词：类风湿关节炎 重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白 来氟米特 超短波 

分 类 号：R684[医药卫生—骨科学]