甲氨蝶呤联合糖皮质激素治疗皮肌炎患者的安全性研究

Study on the safety of methotrexate combined with glucocorticoid in the treatment of patients with dermatomyositis

目的观察甲氨蝶呤联合糖皮质激素治疗皮肌炎患者的临床安全性。方法选取2010年1月—2013年12月在我院接受治疗的皮肌炎患者100例,按照随机数字表的方法,随机分为观察组和对照组。观察组50例患者采用甲氨蝶呤联合糖皮质激素治疗,对照组50例患者采用单纯糖皮质激素治疗。总疗程为6个月,治疗结束后观察患者临床疗效,比较两组患者治疗的有效率、肌酶谱、肌力改变情况及不良反应发生率。结果观察组治疗的有效率(70%)显著高于对照组(50%)(P<0.05),治疗后两组患者的血清肌酶谱和治疗前相比,差异均具有统计学意义(P<0.05),两组患者治疗后的肌酶谱差异具有统计学意义(P<0.05),观察组的药物不良反应发生率(10%)显著低于对照组的不良反应发生率(40%)(P<0.05)。结论甲氨蝶呤联合糖皮质激素治疗皮肌炎效果显著,能够显著改善患者的肌酶谱,减轻由于使用糖皮质激素导致的各种不良反应,改善患者的症状。

Objective To observe the safety of methotrexate combined with glucocorticoid in the treatment of patients with dermatomyositis. Methods Total 100 patients with dermatomyositis,from January 2010 to December 2013,treated in our hospital,according to random number table,divided into observation group（n=50） and control group（n=50）. The observation group toke methotrexate combined with glucocorticoid therapy,the control group was treated with glucocorticoid. The total course of treatment lasted for 6 months,then the curative effect was evaluated and the efficiency of two groups were compared,as well as muscle enzymes,muscle strength changes and adverse reactions. Results The effective rate of observation group（70%） was significantly higher than the control group（50%）（P〈0.05）; to be compared with before treatment,the serum muscle enzyme spectrum of the two groups both have significant improvement（P〈0.05）; muscle enzyme spectrum of the two groups after treatment had significant difference（P〈0.05）; the incidence of adverse reactions of the observation group（10%） was signifi cantly lower than that of the control group（40%）（P〈0.05）. Conclusion The therapeutic effect of methotrexate combined with glucocorticoids in the treatment of dermatomyositis is remarkable,which can significantly improve the muscle enzyme spectrum in patients and reduce a variety of adverse reactions caused by corticosteroids,as well as improve the symptoms of patients,so the combined treatment is worthy of application.