甲氨蝶呤治疗类风湿关节炎的常见不良反应分析

Analysis of Common Adverse Reactions of Methotrexate Tablets in The Treatment of Rheumatoid Arthritis

目的:探究甲氨蝶呤(Methotrexate,MTX)治疗类风湿关节炎的常见不良反应情况。方法:选择本院2017年1月—2020年12月收治的118例类风湿性关节炎患者为研究对象,按随机数法随机分为两组,MTX组和MTX+叶酸组,每组59例。MTX组采用甲氨蝶呤片治疗,MTX+叶酸组采用甲氨蝶呤片联合叶酸片治疗。分析对比治疗后两组患者C反应蛋白(CRP)、红细胞沉降率(ESR)及类风湿因子(RF)等临床指标及用药依从性、不良反应情况。结果:治疗后,MTX+叶酸组患者的CRP(4.59±1.57)mg/L、ESR(21.59±1.85)mm/h和RF(32.58±8.5)指标与MTX组指标CRP(5.01±2.88)mg/L、ESR(22.05±2.14)mm/h和RF(33.21±7.4)指标对比,差异无统计学意义(P> 0.05)。MTX+叶酸组患者用药依从性高于MTX组(81.36%>64.41%),差异有统计学意义(Z=-2.089,P=0.037)。MTX+叶酸组总不良反应率低于MTX组(23.73%<57.63%),差异有统计学意义(χ^(2)=14.048,P <0.05)。结论:应用甲氨蝶呤治疗类风湿性关节炎,不良反应较多,联合叶酸治疗可降低不良反应发生率,患者依从性高,且治疗效果相似。

Objective: Explore the common side effects of methotrexate(MTX) in the treatment of rheumatoid arthritis. Methods: A sample of 118 patients with rheumatoid arthritis admitted to our hospital from January 2017 to December 2020 was selected and randomly divided into two groups according to the random number method, MTX group and MTX+folic acid group, with 59 cases in each group. The MTX group was treated with methotrexate tablets, and the MTX+folic acid group was treated with methotrexate tablets combined with folic acid tablets. After the treatment, the two groups of patients were analyzed and compared clinical indicators such as C-reactive protein(CRP), erythrocyte sedimentation rate(ESR) and rheumatoid factor(RF), as well as medication compliance and adverse reactions. Results: The total adverse reaction rate in the MTX+folic acid group was lower than that in the MTX group(23.73% < 57.63%), and the difference was statistically significant(χ^(2)= 14.048, P < 0.05). After treatment, the CRP(4.59±1.57) mg/L, ESR(21.59±1.85) mm/h and RF(32.58± 8.5) indexes of the MTX+folic acid group were compared with those of the MTX group CRP(5.01±2.88) mg/L, ESR There was no statistically significant difference between(22.05±2.14)mm/h and RF(33.21±7.4) indicators(P>0.05). The medication compliance of patients in the MTX+folic acid group was higher than that in the MTX group(81.36% > 64.41%), and the difference was statistically significant(Z=-2.089, P=0.037). Conclusion: The application of methotrexate in the treatment of rheumatoid arthritis, more adverse reactions, combined with folic acid treatment can reduce the incidence of adverse reactions, patients with high compliance, and treatment effect is similar.