沙利度胺治疗难治性类风湿关节炎的疗效和安全性分析

Clinical efficacy and safety of thalidomide on refractory rheumatoid arthritis

目的 探究重组血小板生成素（rhTPO）治疗成人重型原发免疫性血小板减少症（ITP）的疗效及安全性.方法 选取成人重型ITP患者94例作为研究对象,根据随机数字表法分为观察组与对照组,每组47例.观察组采用rhTPO治疗,对照组采用糖皮质激素治疗,两组疗程均为2周,疗程结束后比较两组疗效、安全性和不良反应发生情况.结果 观察组治疗有效率（87.2％）高于对照组（63.8％）,差异有统计学意义（P〈0.05）.治疗后,两组间各安全指标比较差异未见统计学意义（P〉0.05）.观察组不良反应发生率（8.5％）与对照组（12.5％）比较,差异未见统计学意义（P〉0.05）.结论 rhTPO治疗成人重型ITP疗效显著,优于常规的糖皮质激素治疗,且具有较高的安全性,不良反应发生率低,值得临床推广.

Objective To observe the clinical efficacy and safety of thalidomide on refractory rheumatoid arthritis （RA）. Methods Sixty-nine patients with refractory RA were selected, and they administrated thalidomide for 6 months as continuous treatment. The time of morning stiffness, joint swelling, joint tenderness, health assessment questionnaire （HAQ）, rheumatoid factor （RF）, erythro-cyte sedimentation rate （ESR）, C-reactive protein （CRP） before and after treatment were observed. Results In 69 patients with refractory RA, 29 cases got markedly improvement （42%）, 22 cases were improved （32%）, 11 cases were partially alleviated (16%), while treatment was ineffective in 7 cases (10%), and the total effective rate was 74%. After treatment, the clinical symptoms and auxiliary ex-aminations of patients were significantly improved (P 〈 0. 01). There were 24 cases of drowsiness, 6 cases of dizziness and 3 cases of dry mouth, the symptoms disappeared spontaneously after 6 weeks of continuous treatment. Conclusions Thalidomide can significantly improve the condition of patients with refractory RA, with less adverse reactions, it is especially suitable for other patients with poor curative effect and limited economic conditions, and is worthy of clinical application.