关节腔内注射肿瘤坏死因子受体抗体融合蛋白对难治性类风湿关节炎患者关节积液情况、膝关节功能及ACPA水平的影响  

Influences of Intra-articular Injection of Tumor Necrosis Factor Receptor Antibody Fusion Protein on Joint Effusion,Knee Joint Function and ACPA Level in Patients with Refractory Rheumatoid Arthritis

作　　者：吴旭强[1] 郑冰[1] 顾维杰[1] 朱勇[1] WU Xuqiang;ZHENG Bing;GU Weijie;ZHU Yong(Rheumatic Immune Department,Chengdu Fifth People’s Hospital,Chengdu 611130,China)

机构地区：[1]成都市第五人民医院风湿免疫科,四川成都611130

出　　处：《标记免疫分析与临床》2024年第1期118-122,共5页Labeled Immunoassays and Clinical Medicine

基　　金：四川省卫生和计划生育委员会科研课题-膝关节腔注射肿瘤坏死因子受体抗体融合蛋白治疗类风湿关节炎的难治性关节积液(编号:2018117)。

摘　　要：目的 探讨关节腔内注射肿瘤坏死因子受体抗体融合蛋白[rhTNFR:Fc,益赛普(etanercept)]对难治性类风湿关节炎(RA)患者关节积液情况、膝关节功能及抗瓜氨酸肽抗体(ACPA)水平的影响。方法 选取我院收治的难治性RA患者为研究对象,分为两组。对照组患者给予甲氨蝶呤片等常规基础治疗,研究组在对照组基础上于患者关节腔内注射rhTNFR:Fc治疗,观察治疗后两组患者关节积液情况、膝关节功能及ACPA水平的变化。结果 研究组治疗有效率高于对照组(P<0.05)。治疗后,研究组患者关节积液深度、滑膜厚度低于对照组(P<0.05);VAS评分低于对照组(P<0.05);Lysholm膝关节功能评分高于对照组(P<0.05);血沉(ESR)、C反应蛋白(CRP)、ACPA水平低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 于难治性RA患者关节腔内注射rhTNFR:Fc疗效明显,能够减少关节积液量,改善膝关节功能,延缓病情发展。Objective To investigate the influences of intra-articular injection of tumor necrosis factor receptor antibody fusion protein(rhTNFR:Fc,etanercept)on joint effusion,knee joint function and anti-citrullinated peptide antibody(ACPA)level in patients with refractory rheumatoid arthritis(RA).Methods RA patients with repeated knee joint effusion in our hospital were selected and divided into the control group and research group for the current study.Patients in the control group were given conventional basic treatment such as methotrexate tablets,while the research group were injected with rhTNFR:Fc into the joint cavity on the basis of the control group.The changes in joint effusion,knee joint function and ACPA level in these two groups after treatment were observed.Results The effective rate of treatment in the study group was higher than that in the control group(P<0.05).After treatment,the joint effusion depth and synovial thickness in the study group were lower than those in the control group(P<0.05);VAS score was lower than that of the control group(P<0.05);Lysholm knee function score was higher than that of the control group(P<0.05);Levels of ESR,CRP and ACPA in the control group were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Intra-articular injection of rhTNFR:Fc in refractory RA patients has significant curative effect:it can reduce joint effusion,improve knee joint function,and delay the development process of the disease.

关 键 词：肿瘤坏死因子受体抗体融合蛋白 难治性类风湿关节炎 关节积液 膝关节功能 抗瓜氨酸肽抗体 

分 类 号：R593.22[医药卫生—内科学]