不同剂量依那西普联合来氟米特治疗老年类风湿关节炎临床观察  

Clinical Observation of Different Doses of Etanercept Combined with Leflunomide in the Treatment of Elderly Rheumatoid Arthritis

作　　者：孙凤艳[1] 冯红卫 刘振 齐欣欣 刘静[1] 王晓磊[1] 姜淑华[1] SUN Fengyan;FENG Hongwei;LIU Zhen;QI Xinxin;LIU Jing;WANG Xiaolei;JIANG Shuhua(Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei,China 061001;Cangzhou People's Hospital,Cangzhou,Hebei,China 061001)

机构地区：[1]河北省沧州中西医结合医院,河北沧州061001 [2]河北省沧州市人民医院,河北沧州061001

出　　处：《中国药业》2023年第16期96-99,共4页China Pharmaceuticals

基　　金：河北省医学科学研究课题[20191284]。

摘　　要：目的探讨不同剂量依那西普联合来氟米特治疗老年类风湿关节炎(RA)的临床疗效。方法选取沧州中西医结合医院2019年8月至2021年8月收治的老年RA患者96例,按随机数字表法分为观察组和对照组,各48例。两组患者均予来氟米特片口服,对照组、观察组患者分别加予常规剂量(每次25 mg,每周2次)和小剂量(每次25 mg,每周1次)依那西普注射液皮下注射。两组均治疗12周。结果观察组治疗6周时的总有效率为62.50%,显著高于对照组的41.67%(P<0.05);治疗12周时,两组总有效率均有提升且相当(85.42%比87.50%,P>0.05)。与治疗前比较,两组患者治疗6,12周28处关节疾病活动度评分、视觉模拟量表评分及核因子-κB(NF-κB)、肿瘤坏死因子-α(TNF-α)、红细胞沉降率(ESR)、C反应蛋白(CRP)水平均随治疗时间延长而显著下降(P<0.05),且观察组患者治疗6周时的上述指标均显著劣于对照组(P<0.05),治疗12周时的上述指标改善程度与对照组均相当(P>0.05)。观察组不良反应发生率显著低于对照组(4.17%比16.67%,P<0.05)。结论小剂量依那西普联合来氟米特治疗老年RA的疗效及下调NF-κB信号传导通路相关指标的能力,在短期(≤6周)、长期(≥12周)用药时分别劣于或与常规剂量联合来氟米特相当,且能改善患者的关节活动度,减轻疼痛。Objective To investigate the clinical efficacy of different doses of etanercept combined with leflunomide in the treatment of elderly rheumatoid arthritis(RA).Methods A total of 96 elderly patients with RA admitted to the Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from August 2019 to August 2021 were selected and divided into the observation group and the control group by the random number table method,with 48 cases in each group.The patients in the two groups were given Leflunomide Tablets orally,on this basis,the patients in the control group were given the regular-dose Etanercept Solution for Injection(25 mg each time,twice a week)subcutaneously,while the patients in the observation group were given the low-dose Etanercept Solution for Injection(25 mg each time,once a week)subcutaneously.Both groups were treated for 12 weeks.Results After six weeks of treatment,the total effective rate in the observation group was 62.50%,which was significantly higher than 41.67%in the control group(P<0.05).After twelve weeks of treatment,the total effective rates in the observation group and control group were increased and similar(85.42%vs.87.50%,P>0.05).Compared with those before treatment,the Disease Activity Score in 28 Joints(DAS-28),Visual Analogue Scale(VAS)score,nuclear factor-κB(NF-κB),tumor necrosis factor-α(TNF-α),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)levels in the two groups after six and twelve weeks of treatment decreased significantly with the prolongation of treatment time(P<0.05).After six weeks of treatment,the above indexes in the observation group were inferior to those in the control group(P<0.05),while the improvement of the above indexes in the two groups after twelve weeks of treatment was similar(P>0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(4.17%vs.16.67%,P<0.05).Conclusion The efficacy of low-dose etanercept combined with leflunomide in the short-term treatment(≤si

关 键 词：剂量 依那西普 老年 类风湿关节炎 核因子-ΚB 

分 类 号：R969.4[医药卫生—药理学] R979.5[医药卫生—药学]