来氟米特联合甲氨蝶呤对类风湿关节炎患者ESR及CRP的影响

ESR and CRP in the Treatment of Patients with Rheumatoid Arthritis,Leflunomide and Methotrexate

目的:探讨来氟米特联合甲氨蝶呤治疗类风湿关节炎的疗效,以及二者联合应用对类风湿关节炎患者ESR及CRP的影响。方法:选择68例类风湿关节炎患者随机分为治疗组和对照组各34例。对照组予甲氨蝶呤7.5～10mg/周顿服;柳氮磺胺吡啶1.0g/次,每日2次,口服。治疗组予甲氨蝶呤7.5～10mg/周顿服;来氟米特20mg/次,每日1次,口服。服药后3～6周起效,12周时达到稳定有效浓度,此时可减量至10mg,每日1次,口服。比较两组治疗前后血沉(ESR)及C反应蛋白(CRP)水平的变化,进行临床疗效及不良反应的观察。结果:两组治疗前ESR和CRP水平比较无明显统计学差异(P>0.05)。治疗后两组ESR和CRP水平明显下降(P<0.05或P<0.01),且治疗组下降值较对照组更明显,差异有显著性(P<0.05)。治疗后,临床疗效分析发现治疗组的临床总有效率达94.1%,明显高于对照组70.58%,差异有显著性(P<0.05)。结论:来氟米特联合甲氨蝶呤治疗类风湿关节炎安全有效,其作用与其能调节ESR及CRP的水平密切相关。

Objective：Investigate the efficacy of leflunomide and methotrexate treatment of rheumatoid arthritis, as well as the combination of patients with rheumatoid arthritis ESR and CRP. Methods： 68 cases of patients with rheumatoid arthritis were ran domly divided into a treatment group and the control group, 34 cases in each group. The control group received methotrexate 7.5- 10mg/Dayton suits; sulfasalazine 1.0g/times, 2 times a day, orally. Treatment group received methotrexate 7.5--10mg/week ser ving Dayton; leflunomide 20mg/once a day, orally. 3 to 6 weeks after medication onset, 12 weeks to achieve stable and effective con- centration does can be tapered to 10mg, once a day, orally. The two groups were compared before and after treatment of erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） level changes, and conduct the observation of clinical efficacy and adverse re actions. Resolts：the two groups before treatment ESR and CRP levels showed no significant difference （P〉0.05）. After treat ment, the ESR and CRP levels decreased significantly （P%0.05 or P%0.01）, and the decline in value of the treatment group compared with the control group, was significant （P〈0. 05）. After treatment, the clinical efficacy analysis found that the treatment group clinical total effective rate was 94.1 %, significantly higher than 70.58~, the difference was statistically significant （P〈0. 05）. Conclusion： leflunomide and methotrexate treatment of rheumatoid arthritis is safe and effective, and its role with the regulation of ESR and CRP levels is closely related.