活动期类风湿关节炎患者治疗期间白介素6、C反应蛋白变化及临床意义  

Changes and clinical significance of interleukin-6 and C-reactive protein during treatment of patients with active rheumatoid arthritis

作　　者：李裴裴 杨美凤 Li Peipei;Yang Meifeng(Department of Pharmacy,Puyang Hospital of Traditional Chinese Medicine,Puyang,Henan 457001,China;Department of Rheumatology,Puyang Hospital of Traditional Chinese Medicine,Puyang,Henan 457001,China)

机构地区：[1]濮阳市中医医院药剂科,河南濮阳457001 [2]濮阳市中医医院风湿科,河南濮阳457001

出　　处：《齐齐哈尔医学院学报》2025年第8期749-753,共5页Journal of Qiqihar Medical University

摘　　要：目的探讨活动期类风湿关节炎(RA)患者治疗期间白介素6(IL-6)及C反应蛋白(CRP)变化及临床意义。方法选择2021年2月-2023年2月本院收治的108例RA患者为研究对象,所有患者给予艾拉莫德联合柳氮磺吡啶治疗,于治疗前、治疗1个月、治疗2个月及治疗3个月时采用酶联免疫吸附法检测血清IL-6、CRP水平变化,绘制受试者工作特征(ROC)曲线,分析血清IL-6、CRP对RA患者治疗效果的预测价值。结果活动期RA患者治疗前、治疗1个月、治疗2个月、治疗3个月时的IL-6分别为(42.38±4.27)pg/ml、(32.33±4.80)pg/ml、(26.41±4.77)pg/ml、(21.64±4.85)pg/ml,CRP分别为(36.34±4.63)μg/ml、(25.46±4.48)μg/ml、(21.16±4.18)μg/ml、(15.13±3.57)μg/ml,治疗前<治疗1个月<治疗2个月<治疗3个月,差异具有统计学意义(P<0.05)。治疗12周结束后,108例活动期RA患者中,疗效良好87例(80.56%),疗效欠佳21例(19.44%)。治疗前、治疗1个月、治疗2个月、治疗3个月,疗效良好组患者IL-6分别为(42.56±4.30)pg/ml、(31.31±4.34)pg/ml、(25.43±4.41)pg/ml、(20.57±4.46)pg/ml,疗效欠佳组患者IL-6分别为(41.64±4.16)pg/ml、(36.52±4.42)pg/ml、(30.43±4.14)pg/ml、(26.07±3.85)pg/ml,两组IL-6呈逐渐下降趋势,且两组IL-6具有组间、时间、交互效应差异(P<0.05)。治疗前、治疗1个月、治疗2个月、治疗3个月,疗效良好组患者CRP分别为(36.45±4.62)μg/ml、(24.53±4.17)μg/ml、(20.38±3.83)μg/ml、(14.38±3.15)μg/ml,疗效欠佳组患者CRP分别为(35.88±4.78)μg/ml、(29.28±3.68)μg/ml、(24.43±4.06)μg/ml、(18.22±3.60)μg/ml,两组CRP呈逐渐下降趋势,且两组CRP具有组间、时间、交互效应差异(P<0.05)。以Logistic回归分析结果构建预测模型,治疗1个月时:P=-24.552+0.354×IL-6+0.405×CRP,治疗2个月时:P=-17.364+0.326×IL-6+0.308×CRP;绘制ROC曲线提示治疗1个月时及治疗2个月时血清IL-6、CRP单独及联合预测RA患者治疗疗效的AUC值分别为0.799、0.807、0.920、0.802�Objective To explore the changes and clinical significance of interleukin-6(IL-6)and C-reactive protein(CRP)in patients with active rheumatoid arthritis(RA)during treatment.Methods This study included 108 RA patients admitted to our hospital from February 2021 to February 2023.All patients were treated with Iguratimod combined with sulfasalazine.Enzyme linked immunosorbent assay was used to detect changes in serum IL-6 and CRP levels before treatment,at 1 month of treatment,2 months of treatment,and 3 months of treatment.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of serum IL-6 and CRP for the treatment efficacy of RA patients.Results The IL-6 levels in patients with active RA before treatment,at 1 month,2 months,and 3 months of treatment were(42.38±4.27)pg/ml,(32.33±4.80)pg/ml,(26.41±4.77)pg/ml,and(21.64±4.85)pg/ml,respectively.The CRP levels were(36.34±4.63)μg/ml,(25.46±4.48)μg/ml,(21.16±4.18)μg/ml,and(15.13±3.57)μg/ml,respectively.The concentrations of IL-6 and CRP decreased progressively as follows pre-treatment,1 month of treatment,months of treatment,3 months of treatment,and the difference was statistically significant(P<0.05).After 12 weeks of treatment,among the 108 patients with active RA,87 cases(80.56%)showed good efficacy,while 21 cases(19.44%)had poor efficacy.Before treatment,at 1 month,2 months,and 3 months of treatment,the IL-6 levels of patients in the good efficacy group were(42.56±4.30)pg/ml,(31.31±4.34)pg/ml,(25.43±4.41)pg/ml,and(20.57±4.46)pg/ml,respectively.The IL-6 levels of patients in the poor efficacy group were(41.64±4.16)pg/ml,(36.52±4.42)pg/ml,(30.43±4.14)pg/ml,and(26.07±3.85)pg/ml,respectively.The IL-6 levels of the two groups gradually decreased,and there were differences in inter group,time,and interaction effects between the two groups(P<0.05).Before treatment,at 1 month,2 months,and 3 months of treatment,the CRP levels of patients in the good efficacy group were(36.45±4.62)μg/ml,(24.53±4.17)μg/ml,(20.38±3.83)

关 键 词：类风湿关节炎 活动期 白介素6 C反应蛋白 疗效 

分 类 号：R593.22[医药卫生—内科学]