环孢素A联合甲氨蝶呤治疗类风湿性关节炎效果及对TPINP的影响  

Effect of Cyclosporine A Combined with Methotrexate on Rheumatoid Arthritis and Its Effect on TPINP

作　　者：董晓微[1] 张俊华[1] 刘璐 朴文花[1] DONG Xiaowei;ZHANG Junhua;LIU Lu;PIAO Wenhua(Ningxia Hui Autonomous Region People’s Hospital,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院(宁夏眼科医院西北民族大学第一附属医院),宁夏银川750002

出　　处：《中国医学创新》2020年第19期35-38,共4页Medical Innovation of China

摘　　要：目的:探讨环孢素A联合甲氨蝶呤治疗类风湿性关节炎效果及对总Ⅰ型胶原氨基端延长肽(total N-terminal propeptide of typeⅠprocollagen,TPINP)的影响。方法:选取2018年6月-2019年2月本院收治的类风湿性关节炎患者84例,按随机数字表法分为对照组与研究组,每组42例。对照组应用甲氨蝶呤治疗,研究组应用环孢素A联合甲氨蝶呤治疗,比较两组治疗前后骨代谢相关指标、类风湿性关节炎活动相关指标及不良反应发生情况。结果:治疗后,研究组TPINP与25羟维生素D[25(OH)D]均高于对照组,而β-胶原降解产物(β-CTX)低于对照组,差异均有统计学意义(P<0.05)。治疗后,研究组C反应蛋白(CRP)、血沉(ESR)、28处关节疾病活动度积分(disease activity score in 28 joints,DAS28)评分、触痛关节数及肿胀关节数均低于对照组(P<0.05)。研究组不良反应发生率低于对照组(P<0.05)。结论:环孢素A联合甲氨蝶呤治疗类风湿性关节炎患者效果比较理想,可改善骨代谢指标,具有较高的临床应用价值,应进一步推广应用。Objective:To investigate the effect of Cyclosporine A combined with Methotrexate on rheumatoid arthritis and its effect on total N-terminal propeptide of type I procollagen(TPINP).Method:A total of 84 patients with rheumatoid arthritis admitted to our hospital from June 2018 to February 2019 were selected.They were divided into control group and study group according to the random number table method,with 42 patients in each group.The control group was treated with Methotrexate,while the study group was treated with Cyclosporin A combined with Methotrexate.Bone metabolism,rheumatoid arthritis activity related indicators and adverse reactions were compared between the two groups before and after treatment.Result:After treatment,TPINP and 25 hydroxyvitamin D[25(OH)D]in the study group were higher than those in the control group,whileβ-collagen degradation products(β-CTX)were lower than those in the control group(P<0.05).After treatment,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),disease activity score in 28 joints(DAS28),number of tenderness joints and number of swelling joints in the study group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusion:Cyclosporin A combined with Methotrexate in the treatment of patients with rheumatoid arthritis has an ideal effect,can improve the bone metabolism index,has a high clinical application value,should be further promoted.

关 键 词：环孢素A 甲氨蝶呤 类风湿性关节炎 血清总Ⅰ型胶原氨端延长肽 DAS28评分 

分 类 号：R593.22[医药卫生—内科学]