英夫利西单抗联合草酸艾司西酞普兰治疗抑郁症合并类风湿关节炎患者的临床疗效  

Clinical Efficacy of Infliximab Combined with Escitalopram Oxalate in the Treatment of Patients with Depression and Rheumatoid Arthritis

作　　者：林媛媛[1] 邵体红 LIN Yuanyuan;SHAO Tihong(Department of Psychiatry,Wuxi Mental Health Center,Wuxi Jiangsu 214151)

机构地区：[1]无锡市精神卫生中心精神科,江苏无锡214151 [2]安徽医科大学第一附属医院风湿免疫科,安徽合肥230022

出　　处：《医学临床研究》2025年第3期412-415,共4页Journal of Clinical Research

摘　　要：【目的】探讨英夫利西单抗联合草酸艾司西酞普兰治疗抑郁症合并类风湿关节炎患者的临床疗效。【方法】选取2018年1月至2022年3月无锡市精神卫生中心收治的180例抑郁症合并类风湿关节炎患者,按照随机数字表法分为对照组和观察组,每组90例。对照组在基础治疗上口服草酸艾司西酞普兰片治疗;观察组在对照组基础上加用英夫利西单抗治疗,治疗30周。比较两组临床疗效、不良反应发生情况、疼痛评分、抑郁评分、红细胞沉降率(ESR)及肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、类风湿因子(RF)、同型半胱氨酸(Hcy)、脑源性神经营养因子(BDNF)、5-羟色胺(5-HT)、多巴胺、皮质醇水平。【结果】观察组脱落6例,最终84例纳入分析;对照组脱落4例,最终86例纳入分析。治疗后,观察组总有效率为88.10%,显著高于对照组的72.09%,差异有统计学意义(P<0.05)。治疗后,观察组疼痛评分、抑郁评分、ESR及TNF-α、CRP、RF、Hcy、皮质醇水平低于对照组,BDNF、5-HT、多巴胺水平均高于对照组,差异均有统计学意义(P<0.05)。两组药物不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】英夫利西单抗联合草酸艾司西酞普兰治疗抑郁症合并类风湿关节炎患者,可减轻患者关节炎症反应,提高抗抑郁效果。【Objective】To investigate the clinical efficacy of infliximab combined with escitalopram oxalate in the treatment of patients with depression and rheumatoid arthritis.【Methods】A total of 180 patients with depression combined with rheumatoid arthritis admitted to Wuxi Mental Health Center from January 2018 to March 2022 were selected and divided into the control group and the observation group according to random number table method,with 90 cases in each group.The control group was treated with escitalopram oxalate tablets on the basis of basic treatment;The observation group was additionally treated with infliximab for 30 weeks.The clinical efficacy,occurrence of adverse reactions,pain score,depression score,erythrocyte subsidence rate(ESR),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),rheumatoid factor(RF),homocysteine(Hcy),brain-derived neurotrophic factor(BDNF),5-hydroxytryptophan(5-HT)and dopamine were compared between the two groups cortisol levels.【Results】6 cases fell off in the observation group,and 84 cases were included in the analysis.In the control group,4 cases fell off,and 86 cases were included in the analysis.After treatment,the total effective rate of the observation group was 88.10%,which was significantly higher than that of the control group(72.09%),and the difference was statistically significant(P<0.05).After treatment,the pain score,depression score,ESR,TNF-α,CRP,RF,Hcy and cortisol levels in the observation group were lower than those in the control group,while the levels of BDNF,5-HT and dopamine were higher than those in the control group,with statistical significance(P<0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).【Conclusion】Infliximab combined with escitalopram oxalate in the treatment of patients with depression and rheumatoid arthritis can reduce joint inflammation and improve the effect of anti-depression.

关 键 词：抑郁症 关节炎 类风湿 抗体 单克隆 西酞普兰 治疗结果 

分 类 号：R749.42[医药卫生—神经病学与精神病学]