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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

21

期数:

2020年09期

页码:

1325-1328

栏目:

论　著

出版日期:

2020-09-28

文章信息/Info

Title:

Comparison of different treatments of etanercept on joint function and pain degree in patients with rheumatoid arthritis

作者:

程永跃

南阳市西峡县人民医院内分泌风湿科，河南 南阳 474500

Author(s):

CHENGYong-yue

DepartmentofEndocrineandRheumatology, NanyangXixiaCountyPeople’sHospital,Nanyang ,Henan474500,China Correspondingauthor:CHENGYong-yue,E-mail:dagangmaoe@163.com

关键词:

肿瘤坏死因子拮抗剂; 类风湿关节炎; 关节功能; 疼痛作用

Keywords:

Tumor necrosis factor antagonist;  Rheumatoid arthritis;  Joint function;  Pain degree

分类号:

R541.4

DOI:

-

摘要:

目的 探讨肿瘤坏死因子α（TNF-α）拮抗剂不同治疗方式对类风湿关节炎（RA）的关节功能、疼痛作 用，为临床治疗提供参考。方法 选取南阳市西峡县人民医院2015年1月—2018年1月收治的96例RA患者， 随机分成单药组与联合组，每组48例。单药组患者在基础非甾体消炎药的基础上经皮注射依那西普，联合组患者 在单药组用药基础上口服甲氨蝶呤，共治疗4周。比较两组患者关节疼痛及肿胀评分、TNF-α、白细胞介素1 （IL-1）水平、膝关节功能评分、血液流变学指标、生活质量评分及不良反应发生率。结果 治疗后，两组关节 疼痛、肿胀评分、TNF-α和IL-1水平均低于本组治疗前，且两组间关节疼痛、肿胀评分、IL-1水平比较，差 异有统计学意义（P<0.05）。治疗后，联合组患者在关节功能、关节活动度、肌力、稳定性方面的评分高于单药 组，疼痛及屈曲畸形评分低于单药组，差异有统计学意义（P<0.05）。治疗后，联合组患者全血黏度、血浆黏 度、红细胞聚积指数显著低于单药组，红细胞变形指数高于单药组，差异均有统计学意义（P<0.05）。治疗后， 两组患者生活质量各项评分均有提高，联合组患者体力、病情、医疗、一般生活、社会心理、工作人际关系、总 分评分显著高于单药组，差异有统计学意义（P<0.05）。单药组患者不良反应总发生率为6.25%，显著低于联合 组的22.91%，差异有统计学意义（P<0.05）。结论 单纯经皮注射TNF-α拮抗剂在改善患者机体炎症反应、关 节功能、生活质量方面的作用较联合用药差，但单纯经皮注射TNF-α拮抗剂治疗方式可有效降低TNF-α水 平，且安全性较好。

Abstract:

Objective To investigate the effects of different treatments of TNF-α antagonist on joint function and pain degree in patients with rheumatoid arthritis （RA）. Methods Totally96 RA pa-tients（knee joints）admitted to our hospital from January 2015 to January 2018 were selected and ran-domly divided into the single-drug group and the combined-drug group, 48 cases in each group. Pa-tients in the single-drug group were injected with etanercept on the basis of basic non-steroidal anti-inflammatory drugs. Patients in the combined-drug group were given methotrexate bases on the treat-ment plan of the single group. After treatment for4 weeks, the joint pain and swelling score, TNF-α, IL-1 level, knee function score, hemorheology index, quality of life score, and adverse reaction rate were compared between the two groups. Results After treatment, the joint pain and swelling scores, TNF-α and IL-1 levels were decreased in both groups（P<0.05）, and there were significant differences in the joint pain and swelling scores and IL-1 level between the two groups （P<0.05）.The scores of joint function, joint mobility, muscle strength and stability were higher in the combined-drug group than those in the single-drug group（P<0.05）, meanwhile, the pain and flexion deformity scores were lower in the combined-drug group than those in the single-drug group（P<0.05）. The whole blood viscosity, plasma viscosity and erythrocyte accumulation index of the combined-drug group were significantly lower than those of the single-drug group（P<0.05）, and the erythrocyte deforma-tion index of the combined-drug group was higher than that of the single-drug groups （P<0.05）. The scores of physical strength, patient conditions, medical treatment, general life, social psychology, work interpersonal relationship and total score in the combined-drug group were significantly higher than those in the single-drug group（P<0.05）. The overall incidence of adverse reactions in the sin-gle-drug group was significantly lower than that in the combined-drug group（6.25% vs.22.91%,P< 0.05）. Conclusion The combined therapy has a better effect on ameliorating the body’s inflammato-ry response, joint function and quality of life than those of single percutaneous injection of TNF-α an-tagonist, while the single injection can effectively and safely reduces the TNF-α level in RA patients.

参考文献/References:

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备注/Memo

备注/Memo:

作者简介：程永跃，大学本科，主治医师，研究方向: 内分泌、风湿 通信作者：程永跃，E-mail: dagangmaoe@163.com

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更新日期/Last Update: 2020-09-28