TNF-α拮抗剂治疗早期强直性脊柱炎临床效果观察

Clinical efficacy of TNF-α antagonist in treatment of early ankylosing spondylitis

目的观察TNF-α拮抗剂治疗早期强直性脊柱炎的临床疗效,探讨用药安全性。方法回顾性分析62例早期强直性脊柱炎患者的临床资料,采用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(益赛普)治疗作为观察组,采用洛索洛芬钠片治疗为对照组。统计两组病例治疗前及治疗10 w的血沉(ESR)、血清C反应蛋白(CRP)、脊柱疼痛视觉模拟评分(VAS)、晨僵时间、病情活动指数量表评分(BASDAI)、功能指数量表评分(BASFI)、Schober试验距离、不良用药反应。结果治疗10 w后,两组CRP和ESR均降低,但两组间无统计学差异(P> 0.05);治疗10 w后,两组VAS评分、晨僵时间、BASDAI、BASFI降低,Schober试验距离增加,且观察组的改善幅度显著大于对照组(P <0.05)。治疗10 w期间,两组不良反应率无统计学差异(P <0.05),且不良反应症状均较轻微,短期消失,无需治疗。治疗1年,观察组无新增不良反应患者,对照组有2例因胃肠道反应无法耐受,退出洛索洛芬钠片方案的治疗。结论 TNF-α拮抗剂治疗早期强直性脊柱炎,可有效缓解患者临床症状,效果优于洛索洛芬钠片,且治疗的安全性及耐受性好。

Objective To observe the clinical efficacy of TNF-α antagonist in the treatment of early ankylosing spondylitis and explore the safety of medication. Methods The clinical data of 62 patients with early ankylosing spondylitis were retrospectively analyzed. Patients receiving Etanercept(i.e. recombinant human tumor necrosis factor receptor II: IgG Fc fusion protein) constituted the observation group, and patients receiving Loxoprofen sodium tablets constituted the control group. Before the treatment and during the 10 w treatment, erythrocyte sedimentation rate(ESR), serum c-reactive protein(CRP), visual analogue scale(VAS) for spinal pain,duration of morning stiffness, bath ankylosing spondylitis disease activity index(BASDAI), bath ankylosing spondylitis functional index(BASFI), Schober test distance and adverse drug reaction were calculated for patients in both groups. Results After 10 w treatment, CRP and ESR decreased in both groups with no significant difference(P > 0.05). After 10 w treatment, VAS score, duration of morning stiffness, BASDAI and BASFI decreased in the two groups, and the Schober test distance increased;the improvement in the observation group was significantly greater than that in the control group(P < 0.05). During the 10 w treatment, there was no statistical difference in the incidence of adverse reactions between the two groups(P > 0.05), and the symptoms of adverse reactions were both mild and subsided in a short time without treatment. During 1 year treatment, there were no new cases of adverse reactions in the observation group, while two patients in the control group were unable to tolerate the drug due to gastrointestinal reactions and withdrew from the treatment of Loxoprofen sodium tablets. Conclusion In the treatment of early ankylosing spondylitis, TNF-αantagonist can effectively relieve the clinical symptoms of patients. It is superior to loxoprofen sodium tablet, with good safety and tolerance.