托珠单抗对类风湿关节炎合并骨质疏松患者骨代谢的影响

The effect of tocilizumab on bone metabolism in patients with rheumatoid arthritis combined osteoporosis

目的探讨托珠单抗对类风湿关节炎合并骨质疏松患者骨代谢的影响。方法 30例类风湿关节炎患者,在第0周、第4周、第8周分别予以托珠单抗注射液(雅美罗)8mg/kg治疗,第12周观察血液维生素D、血钙、血磷、血清铁蛋白、甲状旁腺激素(PTH)、I型胶原羧基末端肽(CTX)、抗酒石酸酸性磷酸酶(TRACP-5b)、碱性磷酸酶(ALP)、骨钙素(BGP)、I型前胶原氨基末端肽(PINP)、C反应蛋白(CRP)、血沉(ESR)、抗环瓜氨酸肽抗体(CCP)、抗β2糖蛋白1Ig G抗体(GPI)、类风湿因子(RF)、白介素-6(IL-6)水平,以及DEXA法测定骨密度变化。结果托珠单抗治疗12周后,患者CRP、血沉、IL-6、铁蛋白水平较治疗前显著下降(P<0.01)。患者的骨形成指标ALP、BGP、PINP水平下降(P<0.05),但骨吸收指标CTX、TRACP-5b水平下降更明显(P<0.01)。结论托珠单抗能够减轻骨破坏,其原因可能是缓解炎症反应。

Objective To explore the effect of tocilizumab on bone metabolism in patients with rheumatoid arthritis（RA） combined osteoporosis.Methods 30 patients with RA were treated with tocilizumab 8mg/kg at 0、4、8week,clinical laboratory indices and bone mineral density were recorded at week 12.Results The value of CRP,ESR,IL-6,ferritin decrease obviously（P〈0.01）.Bone resorption values combined with bone formation values have significantly decrease.Conclusion tocilizumab can alleviate bone destruction,and the reason maybe that alleviate inflammation.