艾拉莫德联合美洛昔康治疗老年类风湿关节炎的疗效  

Effects of iguratimod combined with meloxicam on elderly patients with rheumatoid arthritis

作　　者：张建丽[1] 崔春婷[1] 侯晓东[2] ZHANG Jianli;CUI Chunting;HOU Xiaodong(Department of Pharmacy,Zhengzhou First People′s Hospital,Zhengzhou 450000,China;Department of Rheumatology and Immunology,the First Affiliated Hospital of He′nan University,Kaifeng 475000,China)

机构地区：[1]郑州市第一人民医院药剂科,郑州450000 [2]河南大学第一附属医院风湿免疫科,开封475000

出　　处：《西北药学杂志》2020年第5期720-724,共5页Northwest Pharmaceutical Journal

基　　金：国家自然科学基金项目(编号:81601368)。

摘　　要：目的探讨艾拉莫德联合美洛昔康对老年类风湿关节炎(EORA)患者的临床疗效及对血清可溶性程序性死亡蛋白-1(sPD-1)及抗环瓜氨酸肽(CCP)抗体表达的影响。方法选取100例EORA患者,随机均分为对照组(n=50)与观察组(n=50)。对照组患者给予甲氨蝶呤及美洛昔康片;观察组患者服用艾拉莫德和美洛昔康,均治疗6个月。比较2组患者的关节肿胀数、压痛数和晨僵时间、血小板计数、红细胞沉降率(ESR)、C反应蛋白(CRP)含量、免疫球蛋白G(IgG)水平、免疫球蛋白M(IgM)水平、抗CCP抗体和sPD-1水平,并监控不良反应。结果治疗6个月后,2组患者的关节肿胀数、压痛数和晨僵时间明显较治疗前改善,观察组和对照组的美国风湿病学会20%缓解标准的患者比例(ACR20)改善率分别是84.0%和66.0%(χ^2=4.32,P=0.0377);2组患者的血小板计数、ESR、CRP含量、IgG、IgM、抗CCP抗体和sPD-1均较治疗前显著降低,且观察组低于对照组(P<0.05);观察组和对照组的不良反应发生率分别为10.0%和12.0%,差异无统计学意义(P>0.05)。结论艾拉莫德联合美洛昔康可有效改善EORA患者的临床症状,降低血清sPD-1及抗CCP抗体的表达,且未出现严重的不良反应,值得临床推广应用。Objective To investigate the clinical efficacy of iguratimod combined with meloxicam in elderly patients with senile rheumatoid arthritis(EORA)and effects on serum soluble PD-1(sPD-1)and anti-cyclic citrullinated peptides(CCP)antibody expression.Methods 100 EORA patients were randomly divided into control group(n=50)and observation group(n=50).The patients in the control group were given methotrexate and meloxicam tablets;the patients in the observation group were given erammod and meloxicam for 6 months.The number of joint swelling,tenderness and morning stiffness,platelet count,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)content,immunoglobulin G(IgG)levels,immunoglobulin M(IgM)levels,anti-CCP antibodies and sPD-1 level were compared the adverse reactions were monitored.Results After 6 months of treatment,the joint swelling,tenderness,and morning stiffness of the 2 groups of patients were significantly improved compared with before treatment.The proportion of patients with the American College of Rheumatology 20%remission standard(ACR20)in the observation group and control group were 84.0%and 66.0%,respectively(χ^2=4.32,P=0.0377);the platelet count,ESR,CRP content,IgG,IgM,anti-CCP antibody and sPD-1 of patients in both groups were significantly lower than before treatment,and the observation group was lower than the control group(P<0.05);the incidence of adverse reactions in the observation group and the control group was 10.0%and 12.0%,respectively,and the difference was not statistically significant(P>0.05).Conclusion Elamomod combined with meloxicam can effectively improve the clinical symptoms of EORA patients,reduce the expression of serum sPD-1 and anti-CCP antibodies,and there is no serious adverse reactions,which is worthy of clinical application.

关 键 词：艾拉莫德 美洛昔康 老年类风湿关节炎 血清可溶性PD-1 抗CCP抗体 

分 类 号：R971[医药卫生—药品]