羟氯喹与来氟米特联用治疗老年类风湿关节炎的效果及对血脂水平的影响

Effect of combination of hydroxychloroquine and leflunomide on elderly rheumatoid arthritis and its in fluence on the blood lipid level

目的探讨羟氯喹联合来氟米特治疗老年类风湿关节炎(RA)的临床效果及对血脂水平的影响。方法抽取2017年1月至2020年1月南阳医学高等专科学校第一附属医院收治的老年RA患者87例为研究对象。采用随机数字表法分为研究组(44例)与常规组(43例)。研究组给予羟氯喹联合来氟米特治疗,常规组给予来氟米特联合甲氨蝶呤治疗。观察比较两组患者治疗效果、血脂水平及并发症。结果治疗后,两组患者关节疼痛、肿胀、视觉模拟评分法(VAS)评分、28-关节活动度评分(DAS28)、晨僵时间及类风湿因子水平均降低,且研究组低于常规组(P<0.05)。治疗后,两组患者血脂水平较治疗前均有所改善,研究组改善优于常规组(P<0.05)。研究组胃肠道反应、肝功能损害、眼反应、皮肤反应、脱发等不良反应发生率(6.81%)低于常规组(25.58%,P<0.05)。结论老年RA患者采用羟氯喹联合来氟米特治疗,能有效改善机体血脂水平,减少不良反应。

Objective To investigate the effect of combination of hydroxychloroquine and leflunomide on elderly rheumatoid arthritis and its influence on the blood lipid level.Methods Eighty-seven elderly patients with rheumatoid arthritis who were admitted to the First Affiliated Hospital of Nanyang Medical College from January 2017 to January 2020 were selected,and divide into study group(44 cases)and conventional group(43 cases)by random number table.The study group was treated with hydroxychloroquine combined with leflunomide,and the conventional group was treated with leflunomide combined with methotrexate.The clinical efficacy,blood lipid levels and adverse reactions of the two groups of patients were observed and compared.Results After treatment,joint pain,swelling,visual analoguescale(VAS)score,28-joint disease activity score(DAS28),morning stiffness time and rheumatoid the degree of factor level of the two groups were decreased,and those in the study group was lower than those in the conventional group(P<0.05).After treatment,the blood lipid levels of the two groups were better than those before treatment,and those in the study group was better than those in the conventional group(P<0.05).The incidence of gastrointestinal reaction,liver function damage,eye reaction,skin reaction,alopecia and other adverse reactions in the study group(6.81%)was lower than that in the conventional group(25.58%,P<0.05).Conclusions The combination of hydroxychloroquine and leflunomide in elderly patients with rheumatoid arthritis has a significant clinical effect,which can effectively improve the body blood lipid level and reduce adverse reactions.