小剂量依那西普治疗早期强直性脊柱炎的疗效分析

Treatment of early ankylosing spondylitis with low dose of etanercept plus methotrexate: An analysis of curative effects

目的评价小剂量依那西普治疗早期强直性脊柱炎的临床疗效和安全性,为降低医疗费用寻求新举措。方法选取早期强直性脊柱炎患者40例,随机分为试验组和对照组,试验组应用依那西普25 mg,皮下注射,1次/周,联合甲氨蝶呤10～15 mg,口服,1次/周;对照组应用NSAID、甲氨蝶呤及反应停或来氟米特,连续12周,治疗前后评估晨僵VAS评分、腰背痛VAS评分、Bath强直性脊柱炎功能指数(BASFI)及血沉等指标,记录不良反应。结果两组治疗后较治疗前晨僵及腰背痛VAS评分、BASFI、血沉均显著改善(P<0.05),试验组治疗后晨僵及腰背痛VAS评分显著低于对照组(P<0.05),而显示试验组临床疗效优于对照组(P<0.05),不良反应轻微。结论小剂量依那西普治疗早期强直性脊柱炎安全有效。

Objective To assess the clinical efficacy and safety of low dose etanereept, a tumor necrosis factor-a inhibitor, in the treatment of early ankylosing spondylitis（AS） so as to decrease the medical costs. Method Forty patients with early AS were divided into two groups at random. Patients in group 1 received etanereept 25mg once a week and methotrexate for 12 weeks. Patients in group 2 received NSAID,methotrexate and thalidomide or leflunomide as control. The VAS score of morning stiffness and pain in low waist, Bath AS functional index （BASFI） and ESR were observed before and after the treatment. Results There were significant improvement in two groups in the VAS score of morning stiffness and pain in low waist, BASFI or ESR after the treatment（P〈0.05）. The VAS score of morning stiffness and pain in low waist in group 1 were too lower than that in group 2 （P〈O.05）. The percentage of patients with good clinical effect was too higher in groupl than that in group2（80% vs 55%, P〈0.05）. And the adverse reaction were little and mild. Conclusion Low dose of entanercept is of efficacy, safety and low cost therapy in treating early AS.