关于北京医院老年类风湿关节炎生物分子靶向治疗的调查研究  

A Survey and Study on Biomolecular Targeted Therapy for Elderly Rheumatoid Arthritis in Beijing Hospital

作　　者：张雪[1,2] 罗彦相[2] 赵丽柯 陈颖娟 程永静[2] 闫慧明[1] ZHANG Xue;LUO Yan-xiang;ZHAO Li-ke;CHEN Ying-juan;CHENG Yong-jing;YAN Hui-ming

机构地区：[1]内蒙古科技大学包头医学院第二附属医院,内蒙古包头014031 [2]北京医院,北京100005

出　　处：《风湿病与关节炎》2024年第7期22-26,共5页Rheumatism and Arthritis

摘　　要：目的:调查近3年就诊于北京医院的老年类风湿关节炎患者生物靶向制剂使用情况、使用及未使用生物靶向制剂治疗联用激素情况,疾病缓解程度、药物使用依从性,以及药物停用情况。方法:选取2019年6月至2022年6月就诊于北京医院的180例老年类风湿关节炎患者为研究对象,利用院内电子病历系统提取患者的就医信息,包括性别、年龄、病程、实验室检查、药物使用情况,及停药原因,采用SPSS 25.0软件进行统计分析。结果:①180例老年类风湿关节炎患者中,选择使用生物分子靶向治疗患者51例,药物选择按比例由高到低依次为:肿瘤坏死因子拮抗剂、Janus激酶抑制剂、白细胞介素-6受体拮抗剂。②追踪规律使用生物靶向制剂者25例,统计患者初诊、用药3个月、6个月肿胀及压痛关节数量、C反应蛋白检测结果等,依据SDAI评分计算公式对患者疾病活动程度进行判断,规律使用生物制剂治疗半年后均可达到疾病缓解。③追踪统计未遵医嘱规律进行药物治疗的26例患者停药原因,其中以感染、肿瘤较为多见。④180例患者中,规律生物分子靶向治疗患者中激素使用率较传统改善病情抗风湿药治疗患者明显减低。结论:目前就诊于北京医院的老年类风湿关节炎患者,生物制剂或分子靶向治疗的药物选择主要为肿瘤坏死因子受体拮抗剂;规律使用生物制剂或分子靶向药物可以有效控制疾病,减轻关节肿痛症状,降低疾病活动度;老年类风湿关节炎治疗过程中应注意监测感染及肿瘤风险,并做好患者随访,与患者家属合作积极促进患者规律用药,减少因依从性差所致停药情况。Objective:To investigate the use of biologically targeted agents,as well as the use and non use of biologically targeted agents in combination with steroids in elderly patients with rheumatoid arthritis(RA)who have visited Beijing Hospital in the past three years,to study the degree of disease remission,medication adherence,and medication discontinuation.Methods:One hundred and eighty elderly RA patients who visited Beijing Hospital from June 2019 to June 2022 were selected as the research subjects.The hospital's electronic medical record system was used to extract medical information of elderly RA patients,including gender,age,disease course,laboratory tests,drug use,and reasons for discontinuation.Software SPSS 25.0 was used for statistical analysis.Results:①Among the elderly patients with RA,51 patients were selected to use biomolecular targeted therapy.The drug selection in descending order of proportion was tumor necrosis factor antagonist,Janus kinase inhibitor,and interleukin-6 receptor antagonist.②Twenty-five cases of patients using targeted biological agents were tracked regularly.The number of swollen and tender joints,C-reactive protein test results,etc.were counted at the initial diagnosis,three and six months of medication,and the degree of disease activity was determined based on the SDAI scoring formula.Regular use of biological agents for treatment for half a year resulted in disease remission.③Tracking and analyzing the reasons for discontinuation of medication in 26 patients who did not follow the prescribed medication regimen showed that infections and tumors were more common.④Among the 180 patients,the hormone use rate in patients treated with regular biomolecular targeted therapy was significantly reduced compared to patients treated with traditional anti rheumatic drugs to improve their condition.Conclusion:Currently,for elderly patients with RA seeking medical treatment in Beijing Hospital,the main drug selection for biological agents or molecular targeted therapies is tumor necrosi

关 键 词：类风湿关节炎 老年 生物制剂 分子靶向药物 疾病活动度 停药因素 调查研究 

分 类 号：R593.22[医药卫生—内科学]