不同剂量益赛普治疗早期强直性脊柱炎的临床比较

Comparisons of clinical effects on early ankylosing spondylitis with different doses of etanercept

目的:评价不同剂量益赛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36例,随机分为小剂量组和大剂量组,应用益赛普联合甲氨蝶呤治疗,益赛普25mg,皮下注射,小剂量组每周一次,大剂量组每周两次,连用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),但两组间无显著差异(P>0.05),小剂量组临床疗效优良率为83.3%,大剂量组为88.9%,也无显著差异(P>0.05),不良反应轻微。结论:小剂量益赛普治疗早期强直性脊柱炎安全有效,花费-收益比高,值得推广。

Objective：To assess the clinical efficacy and safety of different doses of etanercept,a tumor necrosis factor-α inhibitor,in the treatment of early ankylosing spondylitis and decrease the medical costs.Method：Thirty-six patients with early AS were divided into two groups at random.Patients in group 1 received etanercept 25mg once a week and patients in group 2 received etanercept 25mg twice a week.The VAS score of morning stiffness and pain in low waist,Bath AS functional index and ESR were observed before and after the treatment.Results：There were significant improvements in two groups in the VAS score of morning stiffness and pain in low waist,BASFI or ESR after the treatment（P〈0.05）.But there were no significant difference between the two groups.The percentage of patients with good clinical effect was mild higher in group2 than that of in group1（88.9% vs 83.3%,P〈0.05）.And the side effects were little and mild in two groups.Conclusion：It was an efficacy,safety and low cost therapy in treating early AS with low dose of entanercept.