甲氨蝶呤与来氟米特联合治疗类风湿性关节炎患者对Th1/Th2、Treg的影响  

Effect of Methotrexate and Leflunomide on Th1/Th2 and Treg in Patients with Rheumatoid Arthritis

作　　者：李媛[1] 戚务芳[1] 

机构地区：[1]天津市第一中心医院,天津300190

出　　处：《婚育与健康》2019年第12期24-26,共3页Love and Health

基　　金：骨代谢指标在类风湿性关节炎继发骨质疏松中的临床意义项目编号:2012KZ026。

摘　　要：目的探讨在类风湿性关节炎患者中服用甲氨蝶呤与来氟米特联合治疗的临床疗效及患者的Th1/Th2、Treg变化。方法选取我院2016年1月-2017年8月158例类风湿关节炎患者,其中随机分为两组,对照组采用甲氨蝶呤治疗,治理组采用甲氨蝶呤与来氟米特联合治疗,比较两组患者治疗前后的Th1/Th2、Treg,治疗总有效率和症状缓解程度。结果两组患者在治疗前的Th1、Th2、Th1/Th2和Treg指标无显著性差异,在治疗后发现,两组患者的Th1和Th1/Th2均显著降低,Th2和Treg显著升高(P<0.05),且治疗组的变化程度显著大于对照组,两者的Th1/Th2无差异。两组患者在治疗前的CRP,RF和ESR指标无显著性差异,在治疗后发现治疗组和对照组的CRP,RF和ESR指标均显著降低,其中治疗组的降低程度显著高于对照组(P<0.05),具有统计学差异。对照组中总有效率为84.8%,治疗组的总有效率为89.9%,说明两组患者的治疗有效率无显著性差异。两组患者在治疗前具有相似的症状严重程度,在治疗后发现治疗组和对照组的关节肿胀个数,晨僵时间和关节压痛个数均显著减少,其中治疗组的下降程度显著高于对照组(P<0.05)。结论采用甲氨蝶呤与来氟米特联合治疗类风湿性关节炎具有较好的临床治疗效果,值得在临床上推广和应用。Objective To investigate the clinical efficacy and the changes of Th1/Th2 and Treg in combination with methotrexate and leflunomide in rheumatoid arthritis patients.Methods 158 rheumatoid arthritis patients were selected from January 2016 to August 2017 in our hospital.The control group were treated with methotrexate and the treatment guoup were treated with methotrexate and leflunomide.Compared theTh1/Th2,Treg,the total effective rate of treatment and symptom relief before and after treatment.Results Before treatment,there was no significant difference in Th1,Th2,Th1/Th2 and Treg between the two groups.After treated,Th1 and Th1/Th2 were significantly decreased,Th2 and Treg were significantly increased(P<0.05),the degree of change in the treatment group was significantly greater than the control group.There was no significant difference in CRP,RF and ESR between the two groups before treatment.After treatment,the CRP,RF and ESR indexes of the treatment group and the control group were significantly decreased,and the reduction of the treatment group was significantly higher than that of the control group(P<0.05),with statistical differences.The total effective rate was 84.8%in the control group and the total effective rate was 89.9%in the treatment group,indicating no significant difference between the two groups.Both groups had similar severity of symptoms before treatment.After treatment,the number of joint swelling,morning stiffness and the number of joint tenderness in treatment group and control group were significantly decreased,and the decrease in treatment group was significantly higher than the control group(P<0.05).Conclusion The combination of methotrexate and leflunomide in the treatment of rheumatoid arthritis has a good clinical therapeutic effect,which deserves to be popularized and applied clinically.

关 键 词：甲氨蝶呤 来氟米特 类风湿性关节炎 TH1/TH2 

分 类 号：R59[医药卫生—内科学]