摘要
目的探讨艾拉莫德与来氟米特治疗类风湿关节炎(RA)对患者骨代谢及血清免疫球蛋白(IgA、IgG、IgM)的影响。方法选取2017年1月至2019年12月在西安市红会医院就诊的128例RA患者,采用随机数表法分为观察组和对照组各64例。两组患者均进行常规治疗,对照组在此基础上采用来氟米特治疗,观察组则采用艾拉莫德治疗,均治疗6个月。比较两组患者的治疗效果,以及治疗前后的骨代谢指标、炎症因子和免疫因子水平。结果观察组和对照组患者的治疗总有效率分别为73.44%、65.63%,差异无统计学意义(P>0.05);治疗后,观察组患者的骨钙素(BGP)、总Ⅰ型胶原氨基端延长肽(T-PINP)、25羟维生素D[25(OH)D]水平分别为(28.75±5.11)ng/mL、(45.38±9.24)ng/mL、(19.13±4.58)ng/mL,明显高于对照组的(25.27±6.13)ng/mL、(31.85±8.75)ng/mL、(16.32±4.21)ng/mL,β胶原降解产物水平为(0.44±0.12)ng/mL,明显低于对照组的(0.65±0.20)ng/mL,差异均有统计学意义(P<0.05);治疗后,观察组患者的白细胞介素1β(IL-1β)、IL-6、肿瘤坏死因子α(TNF-α)水平分别为(0.31±0.08)μg/L、(143.58±15.27)pg/L、(4.85±1.26)μg/L,明显低于对照组的(0.44±0.11)μg/L、(166.24±16.28)pg/L、(7.52±1.65)μg/L,差异均有统计学意义(P<0.05);治疗后,观察组患者的血清IgA、IgG、IgM水平分别为(2.33±0.67)g/L、(12.72±2.67)g/L、(1.45±0.31)g/L,明显低于对照组的(2.92±0.84)g/L、(15.24±2.34)g/L、(1.76±0.34)g/L,差异均有统计学意义(P<0.05);观察组患者的不良反应发生率为9.38%,明显低于对照组23.44%,差异有统计学意义(P<0.05)。结论艾拉莫德与来氟米特治疗RA均有具有较好的临床效果,但艾拉莫德在改善骨代谢和免疫功能方面更好。
Objective To explore the effects of Iguratimod and leflunomide on bone metabolism,serum immunoglobulin A(IgA),IgG,and IgM in patients with rheumatoid arthritis(RA).Methods A total of 128 RA patients treated in Xi'an Honghui Hospital from January 2017 to December 2019 were enrolled and divided into observation group and control group by random number table method,with 64 patients in each group.Both groups were given routine treatment.On this basis,the control group was treated with leflunomide,while the observation group was treated with Iguratimod,both for 6 months.The curative effect,levels of bone metabolism indexes,inflammatory factors,and immune factors before and after treatment were compared between the two groups.Results There was no significant difference in total response rate of treatment between the observation group and the control group(73.44%vs 65.63%,P>0.05).After treatment,levels of bone gamma-carboxyglutamic-acid-containing proteins(BGP),total-type I collagen N-terminal propeptide(T-PINP),and 25-hydroxyvitamin D[25(OH)D]in the observation group were(28.75±5.11)ng/mL,(45.38±9.24)ng/mL,and(19.13±4.58)ng/mL,significantly higher than(25.27±6.13)ng/mL,(31.85±8.75)ng/mL,(16.32±4.21)ng/mL in the control group,while level ofβ-crosslaps(β-CTX)was(0.44±0.12)ng/mL,significantly lower than(0.65±0.20)ng/mL in the control group(P<0.05).After treatment,levels of interleukin 1β(IL-1β),IL-6,and tumor necrosis factorα(TNF-α)in the observation group were(0.31±0.08)μg/L,(143.58±15.27)pg/L,and(4.85±1.26)μg/L,significantly lower than(0.44±0.11)μg/L,(166.24±16.28)pg/L,(7.52±1.65)μg/L in the control group(P<0.05).After treatment,levels of IgA,IgG,and IgM in the observation group were(2.33±0.67)g/L,(12.72±2.67)g/L,and(1.45±0.31)g/L,significantly lower than(2.92±0.84)g/L,(15.24±2.34)g/L,(1.76±0.34)g/L in the control group(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in control group(9.38%vs 23.44%,P<0.05).Conclusion The clinical curative effect of both Iguratimod and leflunomide is good on RA.However,Iguratimod is better in terms of improving bone metabolism and immune function.
作者
牛敏
闫美茜
高洁
杨西超
李英
NIU Min;YAN Mei-xi;GAO Jie;YANG Xi-chao;LI Ying(Department of Rheumatology,Immunology and Endocrinology,Xi'an Honghui Hospital,Xi'an 710054,Shaanxi,CHINA;Department of Clinical Immunology,Xijing Hospital,Xi'an 710032,Shaanxi,CHINA;Department of Rheumatology and Immunology,Xi'an International Medical Center Hospital,Xi'an 710100,Shaanxi,CHINA)
出处
《海南医学》
CAS
2021年第10期1252-1255,共4页
Hainan Medical Journal
关键词
类风湿关节炎
艾拉莫德
来氟米特
骨代谢
免疫功能
炎症因子
Rheumatoid arthritis
Iguratimod
Leflunomide
Bone metabolism
Immune function
Inflammatory factor
作者简介
通讯作者:李英,E-mail:392298762@qq.com。
