羟氯喹联合尼达尼布对老年类风湿关节炎合并间质性肺炎治疗有效性及安全性的影响  

Effect on efficacy and safety of Hydroxychloroquine combined with Nintedanib in the treatment of patients with rheumatoid arthritis complicated with interstitial pneumonia

作　　者：唐姣 TANG Jiao(Department of Respiratory Medicine,Liuyang People's Hospital,Liuyang City,Hunan Province,410300,China)

机构地区：[1]湖南省浏阳市人民医院呼吸内科,湖南浏阳410300

出　　处：《蛇志》2025年第1期58-62,共5页Journal of Snake

摘　　要：目的探讨羟氯喹联合尼达尼布治疗老年类风湿关节炎(RA)合并间质性肺炎(IP)的效果及安全性。方法选择2023年1月至2024年12月在我院治疗的老年RA合并IP患者98例,采用随机数字表法分为观察组(49例)和对照组(49例)。观察组给予羟氯喹联合尼达尼布治疗,对照组给予尼达尼布治疗,比较两组的治疗效果、血清炎症因子水平[白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)]、肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气流量(PEF)]、临床症状体征改善情况[发热、咳嗽、气促、肺部啰音消失时间、类风湿性关节炎病情活动度评价表(DAS28)评分、晨僵时间、关节肿胀指数(SJC)和视觉模拟评分法(VAS)评分情况]及不良反应发生情况。结果观察组的临床疗效高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的IL-6、CRP、PCT水平比较,差异均无统计学意义(均P>0.05);治疗后,两组患者的IL-6、CRP、PCT水平均低于治疗前,且观察组的各指标水平均低于对照组,差异均有统计学意义(均P<0.05)。治疗前,两组患者的FEV1、FVC、PEF水平比较,差异均无统计学意义(均P>0.05);治疗后,两组患者的FEV1、FVC、PEF水平均高于治疗前,且观察组各指标水平均高于对照组,差异均有统计学意义(均P<0.05)。治疗后,观察组的发热、咳嗽、气促、肺部啰音消失时间及晨僵时间均短于对照组,DAS28及SJC、VAS评分均低于对照组,差异均有统计学意义(均P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论羟氯喹联合尼达尼布治疗老年RA合并IP的效果显著,可有效改善患者的肺功能和炎症因子水平,缓解临床症状,且安全性高,值得临床应用。Objective To explore the efficacy and safety of hydroxychloroquine combined with Nidanib in the treatment of elderly rheumatoid arthritis(RA)complicated with interstitial pneumonia(IP).Methods 98 elderly patients with RA combined with IP treated in our hospital from January 2023 to December 2024 were divided into observation group(49 cases)and control group(49 cases)by random number table method.Observation group was treated with hydroxychloroquine combined with Nidanib,control group was treated with Nidanib.The therapeutic effect,serum inflammatory factor levels[interleukin 6(IL6),C-reactive protein(CRP),procalcitonin(PCT)],pulmonary function indicators[forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximum expiratory flow(PEF)],clinical symptoms and signs of improvement[fever,cough,shortness of breath,Pulmonary rales disappearance time,rheumatoid arthritis disease activity Scale(DAS28)score,morning stiffness time,swollen joint index(SJC)and visual analog scale(VAS)score]and the occurrence of adverse reactions were compared between the two groups.Results The therapeutic effect of observation group was higher than that of control group,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of IL6,CRP and PCT between the two groups(all P>0.05).After treatment,the levels of IL6,CRP and PCT in 2 groups were lower than before treatment,and the levels of all indexes in observation group were lower than control group,with statistical significance(all P<0.05).Before treatment,there was no significant difference in the levels of FEV1,FVC and PEF between 2 groups(P>0.05).After treatment,the levels of FEV1,FVC and PEF in 2 groups were higher than before treatment,and the levels of all indexes in observation group were higher than control group,with statistical significance(all P<0.05).After treatment,the disappearance time of fever,cough,shortness of breath and pulmonary rales in the observation group was shorter than that in th

关 键 词：羟氯喹 尼达尼布 老年类风湿关节炎 间质性肺炎 安全性 

分 类 号：R563.1[医药卫生—呼吸系统] R593.22[医药卫生—内科学]