摘要
目的 探讨对活动性类风湿关节炎采用甲氨蝶呤+羟氯喹及甲氨蝶呤+羟氯喹+来氟米特治疗的临床疗效及对患者血脂及炎症水平的影响。方法 选取2019年5月至2022年5月于新疆医科大学第一附属医院接受治疗的55例活动性类风湿关节炎患者作为研究对象,依照所接受的治疗方案不同分为双联组(28例)和三联组(27例)。双联组给予甲氨蝶呤+羟氯喹治疗方案,三联组给予甲氨蝶呤+羟氯喹+来氟米特治疗方案,比较两组患者血脂与炎症水平以及不良反应发生情况。结果 治疗后,两组患者胆固醇、三酰甘油、C反应蛋白(CRP)、红细胞沉降率(ESR)水平均有所下降(P<0.05),但两组患者胆固醇、三酰甘油、CRP、ESR水平比较差异无统计学意义(P>0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05),其中双联组胃肠道不良反应(25.00%)以及口腔溃疡(17.86%)发生率高于三联组3.70%、0.00%(P<0.05)。结论 在对活动性类风湿关节炎进行治疗时采取甲氨蝶呤+羟氯喹+来氟米特或甲氨蝶呤+羟氯喹均能取得较好的临床疗效,但采用三联法时患者胃肠道不良反应及口腔溃疡发生率更低。
Objective To explore the clinical efficacy of methotrexate+hydroxychloroquine and methotrexate+hydroxychloroquine+leflunomide in the treatment of active rheumatoid arthritis and its influence on blood lipid and inflammation level of patients.Methods Fifty-five patients with active rheumatoid arthritis who were treated in the First Affiliated Hospital of Xinjiang Medical University from May 2019 to May 2022 were selected as the study subjects,and were divided into two groups(28 cases)and three groups(27 cases)according to the different treatment schemes.The double group was given methotrexate+hydroxychloroquine treatment scheme,and the triple group was given methotrexate+hydroxychloroquine+leflunomide treatment scheme.The level of blood lipids,inflammation and adverse reactions between the two groups were compared.Results After treatment,the levels of cholesterol,triacylglycerol,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)in the two groups decreased(P<0.05);but there were no significant differences in cholesterol,triglyceride,CRP and ESR between 2 groups(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).The incidence of gastrointestinal adverse reactions(25.00%)and oral ulcers(17.86%)in the dual group was higher than that in the triple group(3.70%,0.00%)(P<0.05).Conclusion In the treatment of active rheumatoid arthritis,methotrexate+hydroxychloroquine+leflunomide or methotrexate+hydroxychloroquine can achieve better clinical efficacy,but the incidence of gastrointestinal adverse reactions and oral ulcers in patients with triple therapy is lower.
作者
胡永玮
HU Yong-Wei(Rheumatology and Immunology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《中国药物经济学》
2023年第2期101-103,110,共4页
China Journal of Pharmaceutical Economics
关键词
甲氨蝶呤
羟氯喹
来氟米特
活动性类风湿关节炎
血脂
炎症水平
Methotrexate
Hydroxychloroquine
Leflunomide
Active rheumatoid arthritis
Blood fat
Inflammation levels
