甲氨蝶呤联合美洛昔康治疗类风湿关节炎患者对免疫功能及血清ESR、CPR、CCP、RF水平的影响  

Methotrexate combined with meloxicam in treatment of immune function of rheumatoid arthritis patients and influences on serum ESR,CPR,CCP and RF levels

作　　者：郭欣[1] 谭淳予[1] 马玲[1] 周爱萍 潘璐 GUO Xin;TAN Chunyu;MA Ling;ZHOU Aiping;PAN Lu(Department of Rheumatology and Immunology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院风湿免疫科,四川成都610041

出　　处：《西部医学》2020年第12期1759-1762,共4页Medical Journal of West China

基　　金：国家自然科学基金(81501412)。

摘　　要：目的探讨甲氨蝶呤联合美洛昔康治疗类风湿关节炎患者对免疫功能及红细胞沉降率(ESR)、C-反应蛋白(CRP)、抗环胍氨酸肽(CCP)抗体、类风湿因子(RF)水平的影响。方法选取我院2016年1月~2018年9月收治的180例类风湿关节炎患者为研究对象,利用简单随机抽样法分为对照组与观察组,每组90例。对照组采用甲氨蝶呤治疗,观察组在对照组基础上联合美洛昔康治疗,比较两组治疗效果、免疫功能及血清ESR、CPR、CCP、RF水平的变化。结果观察组总有效率(95.56%)高于对照组(86.67%),差异有统计学意义(P<0.05);观察组晨僵时间短于对照组,关节肿胀数、关节压痛数少于对照组,关节疼痛度轻于对照组,DAS28评分低于对照组,差异均有统计学意义(均P<0.05);治疗后,两组分化簇8(CD8+)水平高于治疗前,分化簇4(CD4+)、CD4+/CD8+、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平低于治疗前,差异均有统计学意义(均P<0.05);观察组治疗后ESR、CRP、CCP抗体、RF水平低于对照组,差异有统计学意义(P<0.05)。结论美洛昔康联合甲氨蝶呤治疗类风湿关节炎效果良好,安全性高,对于缓解关节的疼痛、肿胀具有积极作用,能有效调节T淋巴细胞亚群,降低免疫球蛋白水平。Objective To explore treatment of immune function of rheumatoid arthritis(RA)patients by methotrexate combined with meloxicam and influences on levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),cyclic citrullinated peptide(CCP)antibody and rheumatoid factor(RF).Methods 180 RA patients admitted to the hospital from January 2016 to September 2018 were enrolled.They were randomly divided into control group and observation group by simple random sampling,90 cases in each group.The control group was treated with methotrexate.On this basis,observation group was additionally treated with meloxicam.The curative effect and immune function,and changes in levels of serum ESR,CPR,CCP and RF were compared between the two groups.Results The total response rate of observation group was higher than that of control group(95.56%vs 86.67%)(P<0.05).The morning stiffness time of observation group was shorter than that of control group,number of joint swelling and joint tenderness was less than that of control group,joint pain was milder than that of control group,and DAS28 score was lower than that of control group(P<0.05).After treatment,level of differentiation cluster 8(CD8+)in both groups was increased,while levels of differentiation cluster 4(CD4+),CD4+/CD8+,immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)decreased(P<0.05).After treatment,levels of ESR,CRP,CCP antibody and RF in observation group were lower than those in control group(P<0.05).Conclusion The curative effect of methotrexate combined with meloxicam is good on RA,with high safety.

关 键 词：类风湿关节炎 美洛昔康 甲氨蝶呤 红细胞沉降率 

分 类 号：R593.22[医药卫生—内科学]