托珠单抗与糖皮质激素治疗类风湿关节炎的临床效果对比分析

Comparative Analysis of Clinical Effects of Tocilizumab and Glucocorticoids in the Treatment of Rheumatoid Arthritis

目的随访观察应用托珠单抗(TCZ)与糖皮质激素(GC)治疗类风湿关节炎(RA)的疗效与安全性。方法选择2014年11月至2017年7月住院治疗的RA患者33例,根据用药分TCZ组及GC组。测定两组治疗前、治疗4周、12周ESR、CRP及IL-6水平;同时评估DAS28、SDAI评分;记录随访期间不良事件发生情况。结果治疗12周,TCZ组达到ACR20者比例(78.57%)显著高于GC组(36.84%)(P<0.05)。随时间延长两组ESR、CRP、IL-6水平及DAS28、SDAI评分均显著下降(P<0.05),且与GC组比,TCZ组ESR、CRP、IL-6水平及DAS28、SDAI评分更优(P<0.05)。但两组不良事件发生率差异无统计学意义(P>0.05)。结论与GC相比较,TCZ能在短时间内迅速控制RA患者机体炎性反应,改善临床症状和关节功能,且安全性良好。

Objective The efficacy and safety of toltuzumab(TCZ)and glucocorticoid(GC)in the treatment of rheumatoid arthritis(RA)were followed up.Methods From November 2014 to July 2017,33 patients with RA were hospitalized and divided into the TCZ group and the GC group according to the treatment.The levels of ESR,CRP and IL-6 were measured before treatment,4 weeks and 12 weeks after treatment.The DAS28,SDAI scores of patients at each stage were also evaluated.The occurrence of adverse events during follow-up observations was recorded.Results At 12 weeks of treatment,the proportion of ACR20 in the TCZ group(78.57%)was significantly higher than that in the GC group(36.84%)(P<0.05).During treatment,the levels of ESR,CRP,IL-6 and the scores of DAS28,SDAI in the two groups of RA patients were significantly decreased(P<0.05),and compared with the GC group,levels of ESR,CRP,IL-6 and the scores of DAS28,SDAI in the TZC group were better(P<0.05).However,there was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion Compared with GC,TCZ injection can quickly control the body's inflammatory response in a short period of time,improve clinical symptoms and joint function,and has good safety.