益赛普联合甲氨蝶呤治疗老年类风湿关节炎的临床效果观察

Clinical effect of etanercept combined with methotrexate in the treatment of senile rheumatoid arthritis

目的探讨益赛普联合甲氨蝶呤和单纯使用甲氨蝶呤治疗老年类风湿关节炎的临床应用效果。方法选取医院收治的类风湿性关节炎患者100例,随机分为研究组与对照组,每组50例。对照组予甲氨蝶呤治疗,研究组在对照组基础上加用益赛普治疗。观察比较2组症状改善情况、治疗前后血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、C反应蛋白(CRP)等指标以及不良反应发生情况。结果干预后2组关节肿胀数、关节触痛数、晨僵持续时间、VAS评分均较干预前显著降低,且研究组降低幅度大于对照组(P<0.05);干预后2组TNF-α、IL-1及CRP水平均显著降低,且研究组降低幅度大于对照组(P<0.05);研究组不良反应发生率为6.00%,低于对照组的20.00%(P<0.05)。结论益赛普联合甲氨蝶呤治疗老年类风湿关节炎可显著改善患者临床症状,缓解炎性反应,且不良反应发生率较低,值得临床推广应用。

Objective To investigate the clinical efficacy of Yisuppu combined with methotrexate and methotrexate alone in the treatment of rheumatoid arthritis in the elderly. Methods 100 cases of senile rheumatoid arthritis treated in our hospital from January 2016 to December 2017 were divided into 2 groups according to the random number method,50 cases in the control group were treated with methotrexate,and 50 cases in the study group were treated with IXP combined with methotrexate. The number of joint swelling,the number of joint touch pain,the duration of morning stiffness,VAS score,serum tumor necrosis factor-alpha（ TNF-α）,interleukin-1（ IL-1） and C reactive protein（ CRP）,and the incidence of adverse reactions were compared between the two groups. Results There was no significant difference in the number of joint swelling,joint touch pain,morning stiffness,VAS score,TNF-alpha,IL-1 and CRP（ P〈0. 05） before intervention（ P〈0. 05）. After intervention,the number of joint swelling,joint touch pain,morning stiffness,VAS score,TNF-a,IL-1 and CRP decreased significantly in the two groups,and the study group was lower than the control group（ P〈0. 05）. The incidence of adverse reactions in the study group（ 6. 00%） was significantly lower than that in the control group（ 20. 00%）,which was significantly lower than that in the control group（ P〈0. 05）. Conclusion The treatment of elderly rheumatoid arthritis with methotrexate can significantly improve the clinical symptoms,alleviate the inflammatory reaction,and the incidence of adverse reactions is low. It is worth popularizing in clinical practice.