托法替布与依那西普治疗类风湿关节炎的效果与安全性对比  

Comparison of Effect and Safety of Tofacitinib and Etanercept in the Treatment of Rheumatoid Arthritis

作　　者：陈艳[1] 陈慧龙[1] 陈珊珊 钟彩玲[1] 李叶梅 高利霞[1] CHEN Yan;CHEN Huilong;CHEN Shanshan;ZHONG Cailing;LI Yemei;GAO Lixia(Zhanjiang Central People’s Hospital,Zhanjiang 524037,China)

机构地区：[1]湛江中心人民医院,广东湛江524037

出　　处：《中外医学研究》2022年第27期23-26,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：湛江市科技计划项目(2020B01117)。

摘　　要：目的:探讨托法替布对比依那西普治疗类风湿关节炎的临床效果与安全性。方法:筛选2020年7月-2021年12月在湛江中心人民医院收治的64例类风湿关节炎患者,按照随机数字表法将患者分成A组(32例)和B组(32例)。A组采用托法替布+甲氨蝶呤治疗,B组采用依那西普+甲氨蝶呤治疗,对比两组美国风湿病学会改善标准(ACR)达标率情况、关节肿胀数、关节压痛数及晨僵时间、血清C反应蛋白(CRP)、红细胞沉降率(ESR)水平、疾病活动度(DAS28)评分及疼痛视觉模拟评分法(VAS)评分、不良反应的发生情况。结果:(1)A组ACR20、ACR50、ACR70达标率分别为96.87%、78.12%、53.13%,B组ACR20、ACR50、ACR70达标率分别为87.50%、62.50%、31.25%,差异无统计学意义(P>0.05);(2)治疗后,A组关节肿胀数、关节压痛数及晨僵时间较B组低(P<0.05);(3)治疗后,A组CRP、ESR水平较B组低(P<0.05);(4)治疗后,A组DAS28评分、VAS评分较B组低(P<0.05);(5)A组不良反应总发生率为6.25%,B组不良反应总发生率为25.00%,A组低于B组(P<0.05)。结论:相比于依那西普治疗类风湿关节炎,托法替布具有更为显著的临床疗效,可有效抑制炎性因子,改善患者临床症状,减轻患者痛苦,可为临床治疗该疾病提供参考价值。Objective:To investigate the clinical efficacy and safety of Tofacitinib versus Etanercept in the treatment of rheumatoid arthritis.Method:Sixty-four patients with rheumatoid arthritis admitted to Zhanjiang Central People’s Hospital from July 2020 to December 2021 were screened,and were divided into group A (32 cases) and group B (32 cases) by random number table method.The group A was treated with Tofacitinib+Methotrexate,and the group B was treated with Etanercept+Methotrexate.The American College of Rheumatology improvement criteria (ACR) good control rate,joint swelling number,joint tenderness number and morning stiffness time,serum C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),disease activity score (DAS28),pain visual analog scale (VAS) score,and the occurrence of adverse reactions were compared between the two groups.Result:(1) The good control rates of ACR20,ACR50,and ACR70 in group A were 96.87%,78.12%,and 53.13%,respectively,while those in group B were 87.50%,62.50%,and 31.25%,respectively,there were no significant differences (P>0.05).(2) After treatment,the joint swelling number,joint tenderness number and morning stiffness time of group A were obviously lower than those of group B (P<0.05).(3) After treatment,the levels of CRP and ESR in group A were obviously lower than those in group B (P<0.05).(4) After treatment,the DAS28 score and VAS score of group A were significantly lower than those of group B (P<0.05).(5) The total incidence of adverse reactions in group A was 6.25%,and the total incidence of adverse reactions in group B was 25.00%,group A was obviously lower than group B (P<0.05).Conclusion:Compared with Etanercept in the treatment of rheumatoid arthritis,Tofacitinib has more significant clinical efficacy,which can effectively inhibit inflammatory factors,improve the clinical symptoms of patients,reduce the pain of patients,and can provide reference value for the clinical treatment of this disease.

关 键 词：托法替布 依那西普 类风湿关节炎 临床效果 红细胞沉降率 C反应蛋白 不良反应 

分 类 号：R593.22[医药卫生—内科学]