甲氨蝶呤联合锝[99Tc]亚甲基二膦酸盐对类风湿关节炎患者超敏C-反应蛋白及肌肉骨骼超声下滑膜厚度变化的影响  

Effect of methotrexate combined with 99Tc methylene diphosphonate on high sensitivity C-reactive protein and thickness of synovial membrane by musculoskeletal ultrasonography in patients with rheumatoid arthritis

作　　者：朱琳 陈鹏 顾向浩 潘涛 ZHU Lin;CHEN Peng;GU Xianghao;PAN Tao(Departmeng of Rheumatology,Xuzhou Hospital of Chinese Medicine,Xuzhou,Jiangsu 221000,China;Color Doppler Room,Xuzhou Hospital of Chinese Medicine)

机构地区：[1]徐州市中医院风湿免疫科,江苏徐州221000 [2]徐州市中医院彩超室

出　　处：《徐州医科大学学报》2019年第10期741-744,共4页Journal of Xuzhou Medical University

摘　　要：目的探讨甲氨蝶呤联合铸[99Tc]亚甲基二膦酸盐注射液对类风湿关节炎患者超敏C-反应蛋白(hs-CRP)及肌肉骨骼超声下滑膜厚度变化的影响。方法选取83例类风湿关节炎患者,随机分为对照组(n=41)和观察组(n=42),对照组口服12.5 mg甲氨蝶呤,观察组于对照组基础上静脉输注5 mg锝[99Te]亚甲基二膦酸盐注射液,均治疗3个月,比较2组临床治疗效果及治疗前后血清hs-CRP水平、滑膜厚度变化情况,并记录2组患者晨僵时间、关节肿胀数、关节压痛数及不良反应发生情况。结果观察组治疗总有效率高于对照组(P<0.05);2组治疗后血清hs-CRP水平较治疗前均显著降低,且观察组低于对照组(P<0.05);2组治疗后滑膜厚度较治疗前均显著变薄,且观察组小于对照组(P<0.05);治疗后观察组关节肿胀及压痛比例、晨僵时间均低于对照组(P<0.05);2组不良反应发生率的差异无统计学意义(P>0.05)。结论甲氨蝶呤联合锝[99Tc]亚甲基二膦酸盐注射液可改善类风湿关节炎患者hs-CRP水平及滑膜厚度,改善关节肿胀,安全性高。Objective To investigate the effect of methotrexate combined with 99Tc methylene diphosphonate(99Tc-MDP)on high sensitivity C-reactive protein(hs-CRP)and trans-synovial thickness by musculoskeletal ultrasonography in patients with rheumatoid arthritis.Methods A total of 83 patients with rheumatoid arthritis were random?ly divided into a control group(n=41)and an observation group(n=42).The control group was given 12.5 mg methotrexate orally,while the observation group was given 5 mg 99Tc-MDP injection intravenously on the basis of the control group for 3 months.The clinical efficacy,serum hypersensitive C-reactive protein(hs-CRP)level and synovial thickness of the two groups were compared before and after treatment.Morning stiffness time,the number of joint swelling,the number of joint tenderness as well as adverse reactions of the two groups were recorded.Results The total effective rate of the observation group(95.24%)was higher than that of the control group(75.61%),the difference was statistically significant(P<0.05).After treatment,the serum hs-CRP level of the two groups was significantly lower than that before treatment,and the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).After treatment,the synovial thickness of both groups was significantly thinner than before treatment,and the synovial thickness of the observation group was thinner than that of the control group after treatment,with statistical significance(P<0.05).After treatment,the ratio of joint swelling and tenderness in the observation group were lower than that in the control group,and the time of morning stiffness in the observation group was shorter than that in the control group,with statistical significance(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Methotrexate combined with 99Tc-MDP injection can improve the hs-CRP level and synovial thickness in patients with rheumatoid arthritis,improve joint

关 键 词：甲氨蝶呤 锝[99Tc]亚甲基二膦酸盐 类风湿关节炎 

分 类 号：R593.22[医药卫生—内科学]