甲氨蝶呤联合来氟米特治疗类风湿关节炎的效果观察

Effects of methotrexate combined with leflunomide on rheumatoid arthritis

目的探讨甲氨蝶呤联合来氟米特治疗类风湿关节炎的临床效果。方法抽取2018年1月至2019年12月驻马店市中心医院收治的202例类风湿关节炎患者为研究对象,根据治疗方法分为观察组(98例)和对照组(104例)。对照组采用来氟米特治疗,观察组在对照组基础上加用甲氨蝶呤治疗。治疗后3个月,观察两组关节功能指标[膝关节活动度(ROM)及美国膝关节协会(KSS)功能评分]、类风湿因子(RF)、炎性因子[血清C反应蛋白(CRP)和一氧化氮(NO)]及不良反应发生情况。结果治疗后,观察组ROM及KSS评分[(98.43±7.33)°、(71.72±8.79)分]高于对照组[(94.45±8.15)°、(60.72±7.68)分],P<0.05。观察组RF水平[(23.64±14.42)IU/ml]低于对照组[(29.69±16.52)IU/ml],P<0.05。观察组CRP、NO水平[(7.04±3.89)mg/L、(21.65±4.14)μmol/L]低于对照组[(11.57±4.61)mg/L、(24.14±4.27)μmol/L],P<0.05。观察组总不良反应发生率高于对照组,但差异未见统计学意义(P>0.05)。结论甲氨蝶呤联合来氟米特有利于改善类风湿关节炎患者的关节功能,降低类风湿因子及炎性因子水平,且不良反应与单一用药差别不大。

Objective To investigate the effects of methotrexate combined with leflunomide on rheumatoid arthritis.Methods A total of 202 patients with rheumatoid arthritis treated in Zhumadian Central Hospital from January 2018 to December 2019 were enrolled.According to the treatment methods,they were divided into observation group(98 cases)and control group(104 cases).The control group was treated with leflunomide,and the observation group was treated with methotrexate on the basis of the control group.After 3 months of treatment,the joint function indicators,such as range of motion(ROM)and American Knee Society Score(KSS),rheumatoid factor(RF),inflammatory factors,such as serum C-reactive protein(CRP)and nitric oxide(NO),and adverse reactions were observed between the two groups.Results After treatment,the ROM and KSS scores of the observation group were(98.43±7.33)°and 71.72±8.79,respectively,higher than the(94.45±8.15)°and 60.72±7.68 of the control group(P<0.05).The RF level of the observation group was(23.64±14.42)IU/ml,lower than the(29.69±16.52)IU/ml of the control group(P<0.05).The levels of CRP and NO in the observation group were(7.04±3.89)mg/L and(21.65±4.14)μmol/L,respectively,lower than the(11.57±4.61)mg/L and(24.14±4.27)μmol/L in the control group(P<0.05).The total incidence of adverse reactions in the observation group was higher than that in the control group,but the difference was not statistically significant(P>0.05).Conclusions Methotrexate combined with leflunomide is beneficial to improving the joint function and reducing the levels of rheumatoid factor and inflammatory factors,with less adverse reactions in patients with rheumatoid arthritis.