托法替布联合甲氨蝶呤治疗类风湿关节炎的临床效果及对血清选择素表达的影响研究

Study on Clinical Effect and Effect on Expression of Serum Selectin in Patients with Rheumatoid Arthritis Treated with Tofacitinib Combined with Methotrexate

目的:探讨托法替布与甲氨蝶呤联用治疗类风湿关节炎(RA)的效果及对血清选择素表达的影响。方法:选取2018年9月-2020年6月于本院治疗的106例RA患者。采用随机数字表法将患者分为观察组和对照组,各53例。对照组患者给予甲氨蝶呤片联合双醋瑞因胶囊治疗,观察组患者给予甲氨蝶呤片联合枸橼酸托法替布片治疗。比较两组的临床疗效和不良反应发生情况,比较两组治疗前后关节肿胀指数(ASI)、关节疼痛指数(API)、血清中E-选择素和P-选择素的含量。结果:观察组患者的总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的ASI、API比较,差异均无统计学意义(P>0.05);治疗后,观察组的ASI、API均显著低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者血清中E-选择素和P-选择素的含量比较,差异均无统计学意义(P>0.05);治疗后,观察组的E-选择素及P-选择素均显著低于对照组,差异均有统计学意义(P<0.05)。观察组不良反应发生率虽低于对照组,但差异无统计学意义(P>0.05)。结论:托法替布联合甲氨蝶呤治疗RA患者能显著降低血清中选择素含量,有较好的疗效,且安全性较高。

Objective:To investigate the effect of Tofacitinib combined with Methotrexate in the treatment of rheumatoid arthritis(RA)and its effect on serum selectin expression.Method:A total of 106 RA patients treated in our hospital from September 2018 to June 2020 were selected.The patients were divided into the observation group and the control group by random number table method,53 cases in each group.Control group was treated with Methotrexate Tablets combined with Diacerein Capsules,and observation group was treated with Methotrexate Tablets combined with Tofacitinib Citrate Tablets.The clinical efficacy and the incidence of adverse reactions were compared between the two groups.Articulation swelling index(ASI),articulation pain index(API),serum levels of E-selectin and P-selectin were compared between two groups before and after treatment.Result:The total effective rate of the observation group was significantly higher than that the control group,the difference was statistically significant(P<0.05).Before treatment,there were no statistical significance in ASI and API between two groups(P>0.05).After treatment,the ASI and API of the observation group were significantly lower than those of the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in serum E-selectin and P-selectin levels between two groups(P>0.05).After treatment,the levels of E-selectin and P-selectin in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion:Tofacitinib combined with Methotrexate in the treatment of RA patients can significantly reduce the serum selectin content,with good efficacy and high safety.