摘要
目的探讨英夫利西单抗治疗重症多关节炎型幼年特发性关节炎的临床疗效。方法本研究于2010年2月—2013年2月将收治的重症多关节炎型幼年特发性关节炎患儿54例,随机分为研究组和对照组,对照组采用常规治疗(甲氨蝶呤),研究组在常规治疗的基础上采用英夫利西单抗治疗,比较两组的临床治疗效果及安全性。结果研究组和对照组在治疗后晨僵时间、疼痛指数、肿胀指数、肿胀数及握力等临床症状和体征均较治疗前明显改善。其中研究组的晨僵时间、疼痛指数、肿胀数及握力等治疗后改善情况明显优于对照组,差异具有统计学意义(P<0.05)。对比两组患儿实验室指标改变情况,可以发现两组患儿治疗后ESR、CRP及RF等实验室指标均较治疗前明显改善,而且研究组的ESR、CRP及RF等实验室指标改善程度明显优于对照组,差异具有统计学意义(P<0.05)。研究组患儿在治疗12周后ACR20、ACR50和ACR70等方面的疗效均显著优于对照组,差异具有统计学意义(P<0.05)。研究组发生1例胃肠道不适,1例肌酐轻度升高,对照组出现1例胃肠道不适。结论英夫利西单抗治疗重症多关节炎型幼年特发性关节炎安全有效,值得临床推广使用。
OBJECTIVE To investigate the clinical efficacy of infliximab therapy for severe polyarticular juvenile idiopathic arthritis. METHODS In 2010 February -2013 year in February, the study will be treated as severe polyarticular juvenile idiopathic arthritis were randomly divided into study group and control group, the control group with conventional therapy（MTX）, study group was treated with infliximab therapy on the basis of conventional therapy, clinical treatment was used to compare the effect and safety of two groups. RESULTS The study group and the control group after treatment in the time of morning stiffness, pain index, swelling index, and grip strength, swelling the number of clinical symptoms and signs were significantly improved after treatment; the research group, the time of morning stiffness, pain, swelling index number and grip strength improved significantly after treatment as control group, and the difference was statistically significant（t=3.25, 2.98, 3.02, 4.58, P〈0.05）. Changes in two groups were compared and laboratory indexes can be ESR, CRP and RF and other laboratory indexes of children in two groups after treatment were significantly improved compared with before treatment, and the research group of ESR, CRP and RF laboratory indicators improved significantly due to the control group, and the differences were statistically significant（t=3.62, 3.05, 6.98, P〈0.05）. Study on effect of groups of children in 12 weeks after the treatment, ACR20, ACR50 and ACRTO, were significantly better than the control group, and the difference was statistically significant （χ2=13.20, 5.67, 3.98, P〈0.05）. These two groups were no serious adverse reactions, the study group 1 patients had gastrointestinal discomfort, 1 cases of creatinine increased slightly, the control group had 1 case of gastrointestinal discomfort. CONCLUSIONS Infliximab therapy for severe polyarthritis juvenile idiopathic arthritis was safe and effective, worthy of clinical use.
出处
《中国初级卫生保健》
2014年第6期116-118,共3页
Chinese Primary Health Care
