沙利度胺、柳氮磺吡啶、来氟米特联合治疗活动性强直性脊柱炎患者的临床效果  

Clinical Effect of Thalidomide,Salazepyridine and Leflunomide in the Treatment of Active Ankylosing Spondylitis

作　　者：陈丽珍 黄胜立 CHEN Lizhen;HUANG Shengi(Department of Rheumatological Immunity,Putian 95 Hospital,Putian 351100,China)

机构地区：[1]莆田九十五医院风湿免疫,福建莆田351100

出　　处：《中国医药指南》2023年第23期9-12,共4页Guide of China Medicine

摘　　要：目的 探讨柳氮磺吡啶、来氟米特、沙利度胺联合治疗活动性强直性脊柱炎的效果及安全性。方法 回顾分析我院收治的60例活动性强直性脊柱炎患者的临床病历资料,按治疗方法的不同分为对照组和观察组,每组30例,对照组患者给予柳氮磺吡啶、来氟米特联合治疗,观察组患者给予沙利度胺、柳氮磺吡啶、来氟米特联合治疗,两组均连续治疗6个月,治疗前、治疗6个月统计平均腰痛晨僵时间、外周受累关节数、指地距离及扩胸度,进行Schober试验、夜间痛视觉模拟量表(VAS)、脊柱痛VAS、Bath AS活动指数、Bath AS功能指数评估,采用法测定红细胞沉降率(ESR)、C反应蛋白(CRP),评估两组临床疗效,记录不良反应发生情况。结果 观察组治疗6个月后腰痛晨僵时间、外周受累关节数、指地距离分别为(21.26±2.80)min、(0.90±0.55)个、(14.14±4.72)cm,明显低于治疗前[(93.18±10.16)min、(3.16±1.14)个、(30.44±5.05)cm]及对照组治疗后[(32.12±3.08)min、(1.90±0.82)个、(22.05±4.28)cm],扩胸度、Schober试验值分别为(3.12±0.70)cm、(4.96±1.75)cm,明显高于治疗前[(1.98±0.32)cm、(3.33±1.08)cm]及对照组治疗后[(2.55±0.66)cm、(4.15±1.18)cm],差异有统计学意义,P <0.05。观察组治疗6个月后夜间痛VAS、脊柱痛VAS、Bath AS活动指数、Bath AS功能指数评分分别为(2.42±1.02)分、(2.40±1.06)分、(2.04±1.52)分、(2.08±1.36)分,明显低于治疗前[(5.40±1.22)分、(5.55±1.20)分、(6.34±2.18)分、(5.88±2.28)分]和对照组治疗后[(3.56±1.10)分、(3.36±1.08)分、(3.18±1.66)分、(3.03±1.86)分],差异有统计学意义,P <0.05。观察组治疗6个月后ESR、CRP分别为(12.67±7.72)mm/h、(8.34±3.15)mg/L,明显低于治疗前[(50.85±12.33)mm/h、(35.52±7.24)mg/L]和对照组治疗后[(23.03±8.83)mm/h、(13.56±4.25)mg/L],差异有统计学意义,P <0.05。观察组治疗6个月的临床总有效率为93.33%(28/30),明显高于对照组的80.00%(24/30),Objective To investigate the efficacy and safety of salazepyridine,leflunomide and thalidomide in the treatment of active ankylosing spondylitis.Methods Clinical data of 60 patients with active ankylosing spondylitis treated in our hospital were retrospectively analyzed and divided into control group and observation group according to different treatment methods,with 30 cases in each group.Patients in the control group were given combined treatment of salidomide and leflunomide,while patients in the observation group were given combined treatment of thalidomide,salazepyridine and leflunomide.Both groups were treated for 6 months.Before treatment and 6 months after treatment,the mean time of morning stiffness,the number of peripheral involved joints,the distance between finger and ground and the degree of chest enlargement were analyzed.Schober test,VAS of night pain,VAS of spinal pain,Bath AS activity index and Bath AS function index were evaluated.Erythrocyte sedimentation rate(ESR) and reactive protein(CRP) were determined by method.The clinical efficacy of the two groups was evaluated and the occurrence of adverse reactions was recorded.Results After 6 months of treatment,the morning stiffness time of lumbago,the number of peripherally involved joints and the distance between finger and ground were(21.26±2.80) min,(0.90±0.55) and(14.14±4.72) cm in the observation group,which were significantly lower than those before treatment [(93.18±10.16) min,(3.16±1.14) and(30.44±5.05) cm] and control group after treatment [(32.12±3.08) min,(1.90±0.82) cm,(22.05±4.28) cm],the difference was statistically significant,P<0.05.The breast enlargement and Schober test values of(3.12±0.70) cm and(4.96±1.75) cm were significantly higher than those before treatment [(1.98±0.32) cm,(3.33±1.08) cm]and after treatment [(2.55±0.66) cm,(4.15±1.18) cm],the difference was statistically significant,P<0.05.After 6 months of treatment,the scores of night pain VAS,spinal pain VAS,Bath AS activity index and Bath AS function inde

关 键 词：活动性强直性脊柱炎 沙利度胺 药物治疗 安全性 

分 类 号：R593.23[医药卫生—内科学]