托法替尼联合传统DMARDs类药物治疗类风湿性关节炎临床效果观察  

Clinical effect of tofacitinib combined with traditional DMARDs in treatment of rheumatoid arthritis

作　　者：王小蕊[1] 李文倩[1] 解友邦[1] 杨红艳[1] WANG Xiaorui;LI Wenqian;XIE Youbang;YANG Hongyan(Department of Rheumatology and Immunology,Qinghai Provincial People’s Hospital,Xining 810001,China)

机构地区：[1]青海省人民医院血液风湿免疫科,青海西宁810001

出　　处：《陕西医学杂志》2023年第12期1727-1730,共4页Shaanxi Medical Journal

基　　金：青海省科技计划项目(2021-SF-136);白求恩·医学科学研究基金资助项目(TY170BN)。

摘　　要：目的:探讨托法替尼联合传统改善病情抗风湿药(DMARDs)类药物治疗类风湿关节炎的临床效果。方法:选择类风湿关节炎患者78例,随机分为观察组与对照组,各39例。对照组采用传统DMARDs类药物治疗,观察组在对照组基础上采用托法替尼治疗。两组治疗时间均为3个月。比较两组病情活动度、关节恢复情况、炎症反应、免疫功能及不良反应。结果:治疗后,两组类风湿性关节炎病情活动度评价标准(DAS28)评分降低,且观察组更低(均P<0.05);两组关节肿胀数、关节触痛数降低,且观察组更低(均P<0.05);两组晨僵时间缩短,且观察组更短(均P<0.05);两组血清白细胞介素-10(IL-10)、干扰素-γ(IFN-γ)、IL-12水平降低,且观察组更低(均P<0.05);两组血清IL-4、IL-2水平升高,且观察组更高(均P<0.05);两组CD3^(+)、CD4^(+)、CD19^(+)细胞水平升高,且观察组更高(均P<0.05);两组CD8^(+)细胞水平、血清免疫球蛋白G(IgG)水平降低,且观察组更低(均P<0.05)。结论:托法替尼联合传统DMARDs类药物治疗类风湿关节炎的临床效果确切,可改善患者疾病活动度、临床症状,减轻炎症反应,改善免疫功能,且安全性良好。Objective:To investigate the clinical effect of tofacitinib combined with traditional anti-rheumatic drugs(DMARDs)in the treatment of rheumatoid arthritis.Methods:78 patients with rheumatoid arthritis were randomly divided into observation group and control group,39 cases in each group.The control group was treated with traditional DMARDs,and the observation group was treated with tofacitinib based on the control group.Both groups were treated for 3 months.Disease activity,joint recovery,inflammation,immune function and adverse reactions were compared between the two groups.Results:After treatment,the DAS28 score of rheumatoid arthritis was lower in both groups,and lower in the observation group(all P<0.05);the number of joint swelling and tenderness in both groups were decreased,and the observation group was lower(all P<0.05);the morning rigor time of the two groups was shortened,and the observation group was shorter(all P<0.05);serum levels of IL-10,IFN-γand IL-12 in two groups were decreased,and those in observation group were lower(all P<0.05);serum IL-4 and IL-2 levels were increased in both groups,and those in observation group were higher(all P<0.05);the levels of CD3^(+),CD4^(+)and CD19^(+)cells in two groups were increased,and the levels in observation group were higher(all P<0.05);the levels of CD8^(+)cells and serum IgG were decreased in both groups,and were lower in the observation group(all P<0.05).Conclusion:Tofacitinib combined with traditional DMARDs has a definite clinical effect in the treatment of rheumatoid arthritis,which can improve disease activity,clinical symptoms,reduce inflammatory response,improve immune function,and has good safety.

关 键 词：类风湿关节炎 托法替尼 传统改善病情抗风湿药 免疫功能 安全性 炎症反应 

分 类 号：R593.22[医药卫生—内科学]