小剂量甲泼尼龙联合甲氨蝶呤对老年类风湿关节炎患者的影响  

Effects of low-dose methylprednisolone combined with methotrexate on elderly patients with rheumatoid arthritis

作　　者：熊美丽 付欣 王喜凤[1] 侯丽霞 崔东锋[1] Xiong Meili;Fu Xin;Wang Xifeng;Hou Lixia;Cui Dongfeng(Department of Rheumatology and Immunology,the Third People’s Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州市第三人民医院肾病风湿免疫科,450000

出　　处：《国际移植与血液净化杂志》2024年第4期3-5,共3页International Journal of Transplantation and Hemopurification

摘　　要：目的探讨小剂量甲泼尼龙联合甲氨蝶呤对老年类风湿关节炎患者的影响。方法选取郑州市第三人民医院肾病风湿免疫科2020年3月至2023年3月收治的81例老年类风湿关节炎患者作为研究对象,根据数字表法随机分为两组,传统组40例患者口服甲氨蝶呤,联合组41例患者联合小剂量甲泼尼龙治疗,对比两组患者临床疗效、肝肾功能和脑白质疏松进展情况。结果联合组患者治疗总有效率为92.68%(38/41),高于传统组的75.00%(30/40)(P<0.05);治疗后两组患者总胆红素、直接胆红素、尿素氮、血肌酐较治疗前上升,且联合组低于传统组(P<0.05);治疗后,两组患者的脑室旁白质损害和脑深部白质损害评分均较治疗前降低,且联合组低于传统组(P<0.05)。结论小剂量甲泼尼龙联合甲氨蝶呤能够减缓老年类风湿关节炎患者肝肾功能损伤及脑白质疏松的进展,有效提高临床疗效。ObjectiveTo investigate the effect of low-dose methylprednisolone combined with methotrexate on elderly patients with rheumatoid arthritis.MethodsA total of 81 elderly patients with rheumatoid arthritis in Department of Rheumatology and Immunology,the Third People’s Hospital of Zhengzhou from March 2020 to March 2023 were divided into two groups according to random number table method.Forty patients in the traditional group were treated with oral methotrexate,and 41 patients in the combined group were treated with oral methotrexate and low-dose methylprednisolone.The clinical efficacy,liver and kidney function,and the progress of leukoaraiosis of the two groups were compared.ResultsThe total effective rate of the combined group was 92.68%(38/41),which was higher than that of the traditional group(75.00%(30/40))(P<0.05).Total bilirubin,direct bilirubin,urea nitrogen and blood creatinine in two groups were higher than before the treatment,and the combined group were lower than those in the traditional group(P<0.05).The periventricular white matter lesions(PWMLs)and deep white matter lesions(DWMLs)scores of both groups were decreased,and the combined group were lower than those in the traditional group(P<0.05).ConclusionLow-dose methylprednisolone combined with methotrexate can slow the progression of liver and kidney function injury and leukoaraiosis in elderly patients with rheumatoid arthritis,and effectively improve clinical efficacy.

关 键 词：甲泼尼龙 甲氨蝶呤 类风湿关节炎 肝肾功能 脑白质疏松 

分 类 号：R593.22[医药卫生—内科学]