摘要
目的探讨甲氨蝶呤联合来氟米特治疗类风湿性关节炎对血清疼痛介质以及Th1/Th2型细胞因子的影响。方法纳入2018年1月-2020年12月期间北京市石景山医院收治的类风湿性关节炎患者80例为研究对象,采用随机数字表法分为对照组和研究组,每组40例。对照组实施甲氨蝶呤治疗,研究组实施甲氨蝶呤联合来氟米特治疗。比较两组治疗3个月后临床治疗总有效率,治疗前、治疗3个月的血清类风湿因子(RF)、红细胞沉降率(ESR)、C反应蛋白(CRP)、血清前列素E_(2)(PGE_(2))、血浆P物质(SP)、血清白介素-12(IL-12)、Th1型细胞因子γ干扰素(IFN-γ)、Th2型细胞因子白介素-4(IL-4)水平以及不良反应发生率。结果治疗3个月后,研究组临床治疗总有效率为92.50%,高于对照组的75.00%,差异有统计学意义(χ^(2)=4.501,P<0.05)。治疗3个月后,研究组RF、ESR、CRP、血清PGE_(2)、血浆SP、血清IL-12、IFN-γ水平均低于对照组(t=8.089、6.949、16.902、22.319、7.445、11.566、6.180,P均<0.05),血清IL-4水平高于对照组(t=6.312,P<0.05),差异有统计学意义。两组不良反应发生率差异无统计学意义(P>0.05)。结论甲氨蝶呤联合来氟米特方案治疗类风湿性关节炎患者效果显著,可明显控制病情,提高治疗效果,改善血清疼痛介质,更有效调节Th1/Th2型细胞因子平衡,且不增加不良反应发生率。
Objective To study the effect of methotrexate combined with leflunomide on serum pain mediators and Th/1Th2cytokines in the treatment of rheumatoid arthritis.Methods A total of 80 rheumatoid arthritis patients admitted to Beijing Shijingshan Hospital from January 2018 to December 2020 were included,and they were divided into a reference group and a study group by random number table method.The reference group(40 cases)was treated with methotrexate;the study group(40 cases)was treated with methotrexate combined with leflunomide.After 3 months of treatment,serum rheumatoid factor(RF),erythrocyte sedimentation rate(ESR)concentration,C reactive protein(CRP)concentration,serum prostst E_(2)(PGE_(2))concentration,plasma substance P(SP),serum interleukin-12(IL-12)concentration,Th1 cytokineγ-interferon(IFN-γ),Th2 cytokines interleukin-4(IL-4)concentration,and incidence of adverse effects were analyzed.Results After 3 months of treatment,the overall clinical efficiency in the study group was significantly higher than that of the reference group(P<0.05).The RF,ESR,CRP,plasma SP,IL-12,IFN-γconcentrations of the study group were lower than those of the reference group(P<0.05).The serum IL-4 concentration in the reference group was significantly higher than that of the reference group(P<0.05).Conclusion Methotrexate combined with leflunomide had better effect in the treatment of patients with rheumatoid arthritis,which could significantly control the disease,improve the therapeutic effect,improve serum pain mediators,and more effectively regulate the balance of Th1/Th2 cytokines,without increase the incidence of adverse reactions.
作者
徐连那
李旭艳
庞琳娜
孙聪慧
XU Lian⁃na;LI Xu⁃yan;PANG Lin⁃na;SUN Cong⁃hui(Department of Rheumatology and Immunology,Shijingshan Teaching Hospital,Capital Medical University,Beijing Shijingshan Hospital,Beijing 100040,China)
出处
《热带医学杂志》
CAS
2022年第7期983-986,1009,共5页
Journal of Tropical Medicine
基金
北京市属医院科研培育计划项目(PZ2018025)
作者简介
徐连那(1982-),女,研究方向:风湿免疫、骨质疏松,E⁃mail:qiuqiu0000100001@163.com
