免疫净化治疗难治性类风湿性关节炎的有效性研究

Study on the effectiveness of immune purification in the treatment of refractory rheumatoid arthritis

目的探讨免疫净化治疗难治性类风湿性关节炎的有效性。方法选取2018年7月至2020年7月56例难治性类风湿性关节炎患者纳入研究,简单随机化法分为两组,对照组(n=28)给予常规治疗,试验组(n=28)在其基础上给予免疫净化治疗,分析两组临床有效率、治疗前后关节压痛数、关节肿胀数及红细胞沉降率(ESR)、类风湿因子(RF)、28个关节肿痛活动度(DAS28)评分及不良反应发生率。结果试验组的临床有效率为92.86%,高于对照组的71.43%,两组比较,差异有统计学意义(P<0.05)。治疗后,试验组的关节压痛数为(3.14±0.32)个,关节肿胀数为(2.19±0.55)个,低于对照组的关节压痛数(5.45±0.38)个、关节肿胀数(3.46±0.51)个,两组比较,差异有统计学意义(P<0.05)。试验组的ESR为(21.00±5.21)mm/L,RF为(42.37±8.12)U/mL,DAS28评分为(2.33±0.54)分,低于对照组的ESR(35.57±5.32)mm/L、RF(58.88±8.07)U/mL、DAS28评分(3.67±0.52)分,两组比较,差异有统计学意义(P<0.05)。两组均未发生严重不良反应。结论通过免疫净化治疗难治性类风湿性关节炎可提高临床有效性,有效缓解病情。

Objective To explore the effectiveness of immune purification in the treatment of refractory rheumatoid arthritis.Methods A total of 56 patients with refractory rheumatoid arthritis from July 2018 to July 2020 were enrolled in the study.They were divided into two groups by simple randomization.The control group(28 cases)received conventional treatment,and the experimental group(28 cases)was given immune purification treatment on this basis.The clinical effective rate,the number of joint tenderness before and after the treatment,the number of joint swelling and the red blood cell sedimentation rate(ESR),rheumatoid factor(RF),28 joint swelling and pain activity(DAS28)scores,and probability of adverse reactions were analyzed.Results The clinical effective rate of the experimental group was 92.86%,which was higher than 71.43%of the control group.The difference between the two groups was statistically significant(P<0.05).After treatment,the number of joint tenderness(3.14±0.32)and the number of joint swelling(2.19±0.55)in the experimental group were lower than those[(5.45±0.38)and(3.46±0.51)]in the control group.The difference between the two groups was statistically significant(P<0.05).The ESR(21.00±5.21)mm/L,the RF(42.37±8.12)U/mL,and the DAS28 score(2.33±0.54)points in the experimental group were lower than those of the control group[(35.57±5.32)mm/L,RF(58.88±8.07)U/mL,and(3.67±0.52)points],and the difference between the two groups was statistically significant(P<0.05).No serious adverse reactions occurred in the two groups.Conclusion The immune purification in the treatment of refractory rheumatoid arthritis can improve clinical effectiveness and effectively relieve the disease.