英夫利西单克隆抗体对难治性类风湿关节炎的疗效  

Efficacy of infliximab on refractory rheumatoid arthritis

作　　者：徐冬 吕晓伟 程涛 XU Dong;Lü Xiaowei;CHENG Tao(Department of Rheumatology and Immunology,the First Hospital of Zibo,Zibo 255200,China;Department of Hematology,the First Hospital of Zibo,Zibo 255200,China)

机构地区：[1]淄博市第一医院风湿免疫科,淄博255200 [2]淄博市第一医院血液科,淄博255200

出　　处：《西北药学杂志》2021年第5期802-807,共6页Northwest Pharmaceutical Journal

基　　金：国家自然科学基金项目(编号:81610368)。

摘　　要：目的探讨英夫利西单克隆抗体对难治性类风湿关节炎患者血清抗环瓜氨酸肽(anti-CCP)及14-3-3η蛋白的影响。方法选择难治性类风湿关节炎患者150例,按照随机数字表法分为观察组和对照组,每组75例。对照组给予甲氨蝶呤治疗,观察组给予甲氨蝶呤联合英夫利西单克隆抗体治疗,比较2组患者治疗前后的症状、炎性因子、anti-CCP、14-3-3η蛋白、骨代谢、免疫功能和不良反应。结果治疗前2组患者的肿胀关节数量、晨僵时间、关节压痛数量比较差异均无统计学意义(P>0.05);治疗后2组患者的肿胀关节数量、晨僵时间、关节压痛数量均减少,且观察组少于对照组(P<0.05)。治疗前2组患者C-反应蛋白(CRP)、血沉(ESR)、类风湿因子(RF)和肿瘤坏死因子(TNF-α)比较差异无统计学意义(P>0.05),治疗后2组患者CRP、ESR、RF和TNF-α均减小,且观察组小于对照组(P<0.05)。治疗前2组患者anti-CCP、14-3-3η蛋白比较差异无统计学意义(P>0.05),治疗后2组患者anti-CCP、14-3-3η蛋白均减小,且观察组小于对照组(P<0.05)。治疗前2组患者25-羟基维生素[25(OH)D]、骨钙素(N-MID)、总骨Ⅰ型前胶原氨基端延长肽(t-PINP)和Ⅰ型胶原羧基端肽β特殊序列(β-CTX)比较差异无统计学意义(P>0.05),治疗后2组患者25(OH)D、N-MID和t-PINP增加,β-CTX减小,观察组变化程度大于对照组(P<0.05)。治疗前2组患者CD4T+、CD8T+和CD4T+/CD8T+比较差异无统计学意义(P>0.05),治疗后2组患者CD4T+、CD8T+和CD4T+/CD8T+均增加,且观察组变化程度大于对照组(P<0.05)。观察组总不良反应发生率为6.67%,对照组总不良反应发生率为8.00%,差异无统计学意义(P>0.05)。结论英夫利西单克隆抗体可改善患者的临床症状,降低炎症因子和anti-CCP、14-3-3η蛋白表达,调节机体免疫功能和骨代谢,且未增加患者的不良反应。Objective To investigate the effect of infliximab on serum anti cyclic citruline peptide(anti-CCP)and 14-3-3ηprotein in patients with refractory rheumatoid arthritis.Methods 150 patients with refractory rheumatoid arthritis were randomly divided into observation group and control group,75 cases in each group.The control group were given methotrexate treatment,while the observation group were given methotrexate combined with infliximab.The symptoms,inflammatory factors,anti-CCP,14-3-3ηprotein,bone metabolism,immune function and adverse reactions were compared between the 2 groups before and after treatment.Results Before treatment,there was no significant difference in the number of swollen joints,morning stiffness time and joint tenderness between the 2 groups(P>0.05).After treatment,the number of swollen joints,morning stiffness time and joint tenderness in the 2 groups decreased,and the observation group was smaller than the control group(P<0.05).Before treatment,there was no significant difference in C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),rheumatoid factor(RF)and tumor necrosis factor-α(TNF-α)between the 2 groups(P>0.05).After treatment,CRP,ESR,RF and TNF-αof the 2 groups were decreased,and the observation group were smaller than the control group(P<0.05).Before treatment,there was no significant difference in anti-CCP and 14-3-3ηprotein between the 2 groups(P>0.05).After treatment,the anti-CCP and 14-3-3ηprotein of the 2 groups decreased,and the observation group were smaller than the control group(P<0.05).There was no significant diffe-rence 25-dihydroxyvitamin D(25(OH)D),osteocalcin N-MID(N-MID),total procollagen typeⅠamino-terminal propeptide(T-PINP)andβisomer of C-terminal telopeptide of typeⅠcollagen(β-CTX)between the 2 groups before treatment(P>0.05).After treatment,the 25(OH)D,N-MID,t-PINP increased andβ-CTX decreased in both groups.The change degree of the observation group was greater than that of the control group(P<0.05).Before treatment,there was no significant d

关 键 词：英夫利西单克隆抗体 难治性类风湿关节炎 抗环瓜氨酸肽(anti-CCP) 14-3-3η蛋白 

分 类 号：R971[医药卫生—药品]