低剂量泼尼松单用与联合甲氨蝶呤治疗风湿性多肌痛对比研究  

Comparing the efficacy of low-dose prednisone monotherapy and combined therapy with methotrexate in the treatment of polymyalgia rheumatica

作　　者：汪筱莞 徐亮 贾兰兰 冯丹丹 WANG Xiaowan;XU Liang;JIA Lanlan;FENG Dandan(Department of Rheumatology and Immunology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,Anhui,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院风湿免疫科,安徽芜湖241001

出　　处：《皖南医学院学报》2024年第2期126-128,133,共4页Journal of Wannan Medical College

基　　金：芜湖市科技计划项目(2020ms3-4);皖南医学院中青年科研基金项目(WK2020F16,WK2022F16)。

摘　　要：目的:探讨低剂量泼尼松(10 mg/d)单用治疗风湿性多肌痛(PMR)疗效及安全性。方法:收集初诊未治的PMR患者共40例,依据随机数字表法随机分为低剂量泼尼松单用组、联合甲氨蝶呤(MTX)组各20例,进行为期6个月的前瞻性随访对照研究,记录基线时及治疗6个月后的红细胞沉降率(ESR)、C反应蛋白(CRP)、晨僵时间及PMR活动指数(PMR-AS)等临床数据,比较两组间疗效及安全性。结果:两组治疗6个月后ESR、CRP、晨僵时间及PMR-AS等指标均较基线时改善(P<0.05);泼尼松组与泼尼松+MTX组治疗6个月的有效率(85.00%vs.80.00%)比较,差异无统计学意义(P>0.05);两组治疗后达到完全缓解时间[(4.14±1.78)月vs.(3.60±1.71)月]及治疗有效时间[2.00(1.00,5.00)月vs.1.00(1.00,2.75)月]比较,差异无统计学意义(P>0.05);除空腹血糖轻度升高和肝功能损害外,两组未见有其他不良反应。结论:泼尼松10 mg/d单药治疗PMR临床有效且副作用轻微。Objective:To investigate the efficacy and safety of low-dose prednisone monotherapy in the treatment of polymyalgia rheumatica(PMR).Methods:Forty untreated PMR patients were included and randomly divided into low-dose prednisone monotherapy group and combined therapy with prednisone and methotrexate group(prednisone group and prednisone+MTX group,both n=20)according to the random number table method.A prospective follow-up comparative study was conducted for 6 months.The clinical data,including erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),morning stiffness time and PMR activity score,were recorded at baseline and 6 months after treatment,and the efficacy and safety were compared between two groups.Results:Compared with baseline,ESR,CRP,morning stiffness time and PMR activity score in both groups were significantly improved after 6 months of treatment(P<0.05).There was no significant difference in the 6-month effective rates(85.00%vs.80.00%),time to complete remission[(4.14±1.78)months vs.(3.60±1.71)months]and effective treatment time[2.00(1.00,5.00)months vs.1.00(1.00,2.75)months]between the two groups(all P>0.05).No other adverse reactions were observed in both groups except for mild increase in fasting blood glucose and liver function damage.Conclusion:Low-dose prednisone monotherapy is clinically effective in the treatment of PMR with mild side effects.

关 键 词：风湿性多肌痛 泼尼松 甲氨蝶呤 

分 类 号：R593.2[医药卫生—内科学] R969[医药卫生—临床医学]