免疫抑制剂结合生物制剂治疗类风湿关节炎效果

杨腾蛟; 朱珊珊; 陆艳丽; 高钟丽

文章摘要

杨腾蛟，朱珊珊，陆艳丽，高钟丽.免疫抑制剂结合生物制剂治疗类风湿关节炎效果[J].实用中西医结合临床,2023,23(6):6-10

免疫抑制剂结合生物制剂治疗类风湿关节炎效果

Effects of Immunosuppressive Agents Combined with Biological Agents in Treatment of Rheumatoid Arthritis

DOI：

中文关键词: 类风湿关节炎免疫抑制剂生物制剂骨代谢

英文关键词: Rheumatoid arthritis Immunosuppressive agents Biological agents Bone metabolism

基金项目:

作者	单位
杨腾蛟，朱珊珊，陆艳丽，高钟丽	河南省直第三人民医院药剂科；河南省直第三人民医院风湿免疫科；河南省郑州市人民医院临床药学科

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中文摘要:

目的：探讨免疫抑制剂结合生物制剂对类风湿关节炎（RA）患者的作用。方法：选取2019年8月至2021年10月医院治疗的98例RA患者作为研究对象，随机分为观察组和对照组，各49例。对照组采用来氟米特治疗，观察组在对照组基础上联合阿达木单抗注射液治疗，两组均治疗8周。比较两组患者的治疗效果、免疫相关指标、炎症相关指标、骨代谢相关指标、血清相关标志物。结果：治疗8周后，两组患者中医症状评分、晨僵具体时间、关节压痛数量、肿胀关节数量以及RA患者病情评价（DAS28）评分均显著改善，且观察组优于对照组（P＜0.05）；两组患者免疫系统补体C3、补体C4、免疫球蛋白（Ig）A、IgG、IgM均显著升高，且观察组高于对照组（P＜0.05）；两组患者血清指标[骨桥蛋白（OPN）、类风湿因子（RF）、抗环瓜氨酸多肽抗体（anti-CCP）]、炎症相关指标[白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、降钙素原（PCT）]均显著下降，且观察组低于对照组（P＜0.05）；两组患者骨代谢指标[碱性磷酸酶（ALP）、Ⅰ型胶原羧基末端肽（ⅠCTP）、Ⅰ型前胶原羧基端肽（PⅠCP）及骨钙素（BGP）]均显著下降，且观察组低于对照组（P＜0.05）。结论：采用免疫抑制剂结合生物制剂对RA患者进行治疗，患者的骨代谢以及血清学指标和炎症相关指标显著改善，治疗效果显著。

英文摘要:

Objective: To investigate the effects of immunosuppressive agents combined with biological agents on patients with rheumatoid arthritis(RA). Methods: A total of 98 RA patients treated in the hospital from August 2019 to October 2021 were selected as the subjects of the trial and randomly divided into observation group and control group, each group with 49 cases. Both groups were treated with leflunomide, and patients in the observation group were treated with adalimumab injection. Both group were treated for 8 weeks. The therapeutic efficacy, immune related indexes, inflammatory related indexes, bone metabolism related indexes, serum related markers were compared between the two groups. Result: After 8 weeks of treatment, the TCM symptom score, morning stiffness time, number of joint tenderness, number of swollen joints and DAS28 score of two groups were obviously improved, and the TCM symptom score, time of morning stiffness, number of joint tenderness, number of swollen joints and DAS28 score of the observation group were obviously lower than those of the control group(P＜0.05). The complement C3, complement C4, immunoglobulin(Ig)A, IgG and IgM of two groups were obviously increased, and the complement C3, complement C4, IgG, IgA and IgM of the observation group were obviously higher than those of the control group(P＜0.05). The TNF-α, IL-1β, IL-6 and PCT of two groups were obviously descended. The levels of TNF-α, IL-1β, IL-6 and PCT in the observation group were obviously lower than those of the control group, and the differences were statistically obvious (P＜0.05). The ALP, ⅠCTP, PⅠCP lower than those of the control group, and the differences were statistically obvious (P＜0.05). The ALP, ⅠCTP, PⅠCP and BGP of two groups were obviously descended, and the ALP, ⅠCTP, PⅠCP and BGP of the observation group were obviously lower than those of the control group. RF, anti-CCP and OPN of two groups were obviously descended, and the RF, anti-CCP and OPN of the observation group were obviously lower than those of the control group(P＜0.05). Conclusion: Immunosuppressive agents combined with biological agents were used to treat patients with rheumatoid arthritis, bone metabolism and serological indexes of patients were obviously improved, and the treatment effect was obvious.

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