甲氨蝶呤联合来氟米特对膝关节镜滑膜切除术后单膝关节滑膜炎患者的抗CCP抗体水平影响观察

An observation of the effect of methotrexate combined with leflunomide on anti-CCP antibody level in patients with synovitis of single knee joint after arthroscopic synovectomy of the knee joint

目的观察甲氨蝶呤联合来氟米特治疗对单膝关节滑膜炎患者进行膝关节镜滑膜切除术后的抗环瓜氨酸肽(CCP)抗体水平影响。方法回顾性分析2016年2月~2019年2月在我院进行过膝关节镜滑膜切除术后的患者,根据术后给予的药物不同分为甲氨蝶呤组(n=31)与联合组(n=30),甲氨蝶呤组仅口服甲氨蝶呤,一周一次,一次口服10~15mg,治疗4周;联合组在甲氨蝶呤组的基础上联合来氟米特,一日一次口服20mg,治疗4周,比较4周后两组的视觉模拟评分法评分(VAS)、Lysholm评分、血沉、抗CCP、类风湿因子(RF)及生活质量分数。结果经治疗后两组的VAS评分均降低,Lysholm评分均升高,且两组间差异均有统计学意义(P<0.05);血沉、抗CCP抗体、RF水平均有降低,且两组间差异均有统计学意义(P<0.05);联合组的生活质量分数高于甲氨蝶呤组,差异有统计学意义(P<0.05)。结论甲氨蝶呤联合来氟米特减轻术后单膝关节滑膜炎患者的疼痛程度并降低患者的抗CCP抗体水平,对提高患者的生活质量有着积极意义。

Objective To observe the effect of methotrexate combined with leflunomide on anti-CCP(cyclic citrulline peptide)antibody level in patients with synovitis of single knee joint after arthroscopic synovectomy of the knee joint.Methods The patients who underwent arthroscopic synovectomy of the knee joint in our hospital from February 2016 to February 2019 were retrospectively analyzed.They were divided into the methotrexate group(n=31)and the combined group(n=30)according to the different drugs administered after operation.For the case of exclusive administration of methotrexate,it was taken orally once a week and 10-15mg once for 4 weeks.The combined group was treated with leflunomide and it was taken orally once a day and 20mg once for 4 weeks on the basis of the methotrexate group.The VAS(Visual Analogue Scale)scores,Lysholm scores,erythrocyte sedimentation rate(ESR),anti-CCP,RF(rheumatoid factor)and quality of life scores of the two groups were compared after 4 weeks.Results After treatment,the VAS scores of both groups decreased and Lysholm scores of both groups increased,and the differences between the two groups were both statistically significant(P<0.05).The levels of ESR,anti-CCP antibody and RF in both groups decreased,and the differences between the two groups were all statistically significant(P<0.05).The quality of life scores of the combined group were higher than those of the methotrexate group,and the difference was statistically significant(P<0.05).Conclusion Methotrexate combined with leflunomide can reduce the pain degree and the anti-CCP antibody level of the postoperative patients with synovitis of single knee joint.It is of positive significance for improving the patients'quality of life.