摘要
目的 研究类风湿关节炎（RA）患者益赛普（ETA）联合甲氨蝶呤（MTX）治疗后,临床表现及血清肿瘤坏死因子α（TNF-α）、白细胞介素-6（IL-6）、干扰素-γ（IFN-γ）浓度的变化.方法 选取活动性RA患者25例和正常人18例作为研究对象,研究期间患者均给予甲氨蝶呤10 mg每周1次口服,以及益赛普25 mg每周2次,皮下注射.治疗前及治疗后第6周收集患者血清,检测其TNF-α,IFN-γ、IL-6浓度,并记录肿胀关节数、压痛关节数、疾病活动性评分（DAS）、健康评估问卷评分（HAQ）、血沉（ESR）、C反应蛋白（CRP）和类风湿因子（RF）等,同时收集正常人血清检测上述指标.结果 RA组患者血清IL-6、TNF-α和IFN-γ浓度明显高于正常对照组（P分别＜0.01、0.05、0.05）.治疗后患者DAS28评分降低（P＜0.01）,HAQ、ESR、CRP、肿胀及压痛关节数也明显好转（P＜0.01）,血清RF、IL-6和TNF-α浓度也明显下降（P分别＜0.05,0.01,0.05）,治疗后血清IFN-γ浓度较前下降,但无显著性差异.结论 血清IL-6、TNF-α和IFN-γ浓度增高以及ESR、CRP、RF增加可作为RA病情活动指标.益赛普和甲氨蝶呤联合治疗能快速缓解患者关节炎症,并改善关节功能.
Objective Analysis of serum concentrations and modifications of tumor necrosis factor-a（ TNF-a）, IFN -3,,IL-6 and clinical features after therapy with methotrexate（MTX） and anti-TNF（ a- anercept） in patients with rheumatoid arthritis （RA）. Methods Twenty-five patients with active RA and 18 healthy controls were included. The diagnosis of all patients met the American College of Rheumatology 1987 criteria. Disease was considered active when the DAS28 score was 5.1. Patients were treated with a stable dose of MTX of 10 mg/week and etanercept of 25 mg two times per week during inclusion in the study. DAS28,tender and swollen joint count, erythrocyte sedimentation rate （ESR） , Health Assessment Questionnaire scores （ HAQ）, C-reactive protein （ CRP）, rheumatoid factor （ RF ） and serum levels of TNF- a, IFN -γ,IL-6 were determined at baseline and prior to treatment of etanercept and MTX at 6 weeks. Results Serum levels of IL-6, TNF-a and IFN-γ were significantly higher than healthy individuals （P 〈 0. 01,0.05 ,0. 05 respectively）. After treatment of MTX and etanercept, there was a significant decrease in DAS28 and it dropped from 6.63 to 4.87 （ P 〈 0.01 ）. HAQ ESR, CRP, and the number of tender and swollen joints decreased （ P 〈 0.01 ）. RF Levels also improved significantly （ P 〈 0.05 ）. Serum concentra- tion of IL-6 and TNF-a showed a significant decrease after treatment（ P 〈0.01,0.05 respectively）. After treatment serum concentrations of IFN-γ）, also decreased, but there was no significant difference. Conclusion Increased levels of IL-6,TNF-a,IFN -γ ,ESR,CRP and RF are serum markers of active RA. A administration of MTX and etanercept can reduce joint inflammation and improve physical function rapidly.
出处
《临床内科杂志》
CAS
2010年第6期388-390,共3页
Journal of Clinical Internal Medicine
基金
本研究受湖北省自然科学某金资助编号2007ABA123
