甲氨蝶呤片联合来氟米特片对类风湿关节炎患者血清α1-AGP、RF、HMGB1的影响

Effect of methotrexate tablets combined with leflunomide tablets on serum α1-AGP,RF and HMGB1 in patients with rheumatoid arthritis

目的观察甲氨蝶呤片联合来氟米特片对类风湿关节炎患者血清α1-酸性糖蛋白(α1-acidglycoprotein,α1-AGP)、类风湿因子(rheumatoid factor,RF)、高迁移率族蛋白1(high mobility group box 1,HMGB1)的影响。方法选取滕州市中心人民医院(2020年4月至2022年11月)收治的类风湿关节炎患者124例,依据简单随机法分为两组。对照组给予甲氨蝶呤片治疗,观察组给予甲氨蝶呤片联合来氟米特片治疗。记录两组治疗前后临床症状指标、日常生活能力量表量表(activity of daily living scale,ADL)评分、28个关节活动度(28 joint motion scores,DAS28)评分及血清相关因子水平变化,并统计两组总有效率,记录两组不良反应。结果治疗12周后,观察组总有效高于对照组,差异有统计学意义(χ^(2)=4.159,P=0.041)。与治疗前比,两组治疗12周晨僵时间、20 m步行时间缩短,静息视觉模拟(visual analogue scale,VAS)评分、DAS28评分下降,手部握力、ADL评分升高,观察组治疗12周后症状指标、ADL评分、DAS28评分优于对照组(P<0.05);与治疗前比,两组治疗12周血清相关因子下降,观察组治疗12周低于对照组(P<0.05)。治疗期间,观察组不良反应率与对照组比较,差异无统计学意义(χ^(2)=0.260,P=0.610)。结论甲氨蝶呤片联合来氟米特片治疗类风湿关节炎可有效缓解疼痛,调节相关因子的表达,提高生活质量。

Objective To observe the effects of methotrexate tablets combined with leflunomide tablets on serum α1-acidglycoprotein(α1-AGP)and rheumatoid factor in patients with rheumatoid arthritis(rheumatoid factor).RF)and high mobility group box 1(HMGB1).Methods A total of 124 patients with rheumatoid arthritis admitted to our hospital(from April 2020 to November 2022)were selected and divided into two groups according to simple random method.The control group was treated with methotrexate tablets,and the observation group was treated with methotrexate tablets combined with leflunomide tablets.Clinical symptom indexes,activity of daily living scale(ADL)scores,28 joint motion scores(DAS28)scores and serum related factors were recorded before and after treatment in the two groups.The total effective rate of the two groups and the adverse reactions of the two groups were recorded.Results After 12 weeks of treatment,the total effectiveness of the observation group was higher than that of the control group,with statistical significance(χ^(2)=4.159,P=0.041).Compared with before treatment,the morning stiffness time and 20m walking time of the two groups after 12 weeks of treatment were shortened,the resting visual analogue scale(VAS)scores and DAS28 scores were decreased,and the hand grip strength and ADL scores were increased.Symptom index,ADL score and DAS28 score in observation group were better than those in control group after 12 weeks of treatment(P<0.05).Compared with before treatment,serum related factors in both groups decreased after 12 weeks of treatment,and the observation group was lower than the control group after 12 weeks of treatment(P<0.05).There was no significant difference in the adverse reaction rate between the observation group and the control group(χ^(2)=0.260,P=0.610).Conclusion Methotrexate tablets combined with leflunomide tablets in the treatment of rheumatoid arthritis can effectively relieve pain,regulate the expression of related factors and improve the quality of life.