甲氨蝶呤联合托法替布治疗难治性类风湿关节炎的效果及对anti-CCP、IL-6的影响  

The Effect of Methotrexate Combined with Tofacitinib in the Treatment of Refractory Rheumatoid Arthritis and Its Influence on Anti-CCP and IL-6

作　　者：郑江霞[1] 张细凤[1] 刘圣徽 刘炬[1] 闻秀珍 ZHENG Jiangxia;ZHANG Xifeng;LIU Shenghui;LIU Ju;WEN Xiuzhen(Jiujiang NO.1 People’s Hospital,Jiangxi Province,Jiujiang 332000,China;不详)

机构地区：[1]江西省九江市第一人民医院,江西九江332000

出　　处：《中国医学创新》2022年第14期48-52,共5页Medical Innovation of China

摘　　要：目的:探讨甲氨蝶呤联合托法替布治疗难治性类风湿关节炎的效果及对抗环瓜氨酸肽抗体(anti-CCP)、白细胞介素-6(IL-6)的影响。方法:选取九江市第一人民医院自2020年6月-2021年6月收治的100例难治性类风湿关节炎患者,采用随机数字表法分为对照组和观察组,各50例。对照组在常规治疗基础上联合甲氨蝶呤治疗,观察组在对照组基础上加用托法替布治疗。观察两组临床疗效,比较两组治疗前后的晨僵时间、关节肿胀数、关节压痛数、C反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF)、anti-CCP及IL-6水平。结果:治疗6周后,对照组临床总有效率为60.0%,观察组临床总有效率为88.0%;治疗12周后,对照组临床总有效率为76.0%,观察组临床总有效率为96.0%;两组疗效比较,差异均有统计学意义(P<0.05)。治疗6、12周后,观察组关节压痛数、关节肿胀数均少于对照组,晨僵时间均短于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组CRP、ESR及RF均低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后anti-CCP水平相较于对照组更低(P<0.05)。观察组治疗后血清IL-6水平低于对照组,差异有统计学意义(P<0.05)。结论:难治性类风湿性关节炎给予常规治疗的同时联合采用甲氨蝶呤和托法替布治疗,临床效果改善显著,可提高临床总有效率,改善患者症状及体征,并可有效缓解及降低anti-CCP、血清IL-6,值得推广应用。Objective:To explore the effect of Methotrexate combined with Tofacitinib in the treatment of refractory rheumatoid arthritis and its influence on anti-CCP and IL-6.Method:A total of 100 patients with refractory rheumatoid arthritis admitted to Jiujiang NO.1 People’s Hospital from June 2020 to June 2021 were selected and divided into the control group and the observation group by a random number table,with 50 cases in each group.The control group was treated with Methotrexate on the basis of conventional treatment,and the observation group was treated with Tofacitinib on the basis of the control group.The clinical efficacy of the two groups were observed,the morning stiffness time,number of joint swelling,number of joint tenderness,C reactive protein (CRP),erythrocyte sedimentation rate (ESR),rheumatoid factor (RF),anti-CCP antibody and IL-6 levels were compared between the two groups before and after treatment.Result:After 6 weeks of treatment,the total clinical effective rate of the control group was 60.0%,the total clinical effective rate of the observation group was 88.0%;after 12 weeks of treatment,the total effective rate was 76.0% in the control group,the total clinical effective rate of the observation group was 96.0%;there were significant differences between the two groups (P<0.05).After 6 and 12 weeks of treatment,the number of joint tenderness and joint swelling in the observation group were less than those in the control group,and the morning stiffness time were shorter than those in the control group (P<0.05).After treatment,CRP,ESR and RF in the observation group were lower than those in the control group (P<0.05).After treatment,the level of anti-CCP antibody in the observation group was lower than that in the control group (P<0.05).After treatment,the level of serum IL-6 in the observation group was significantly lower than that in the control group (P<0.05).Conclusion:Conventional treatment combined with Methotrexate and Tofacitinib in the treatment of refractory rheumatoid arthritis can signi

关 键 词：托法替布 难治性类风湿关节炎 ANTI-CCP IL-6 

分 类 号：R593.22[医药卫生—内科学]