艾拉莫德联合沙利度胺对强直性脊柱炎患者免疫球蛋白及ESR、C3、C4的影响

Effects of Elamud Combined with Thalidomide on Immunoglobulin,ESR,C3 and C4 in Patients with Ankylosing Spondylitis

目的:探讨艾拉莫德联合沙利度胺对强直性脊柱炎患者免疫球蛋白及血沉(ESR)、补体C3(C3)、补体C4(C4)的影响。方法:选择2016年11月到2019年12月在我院接受治疗的149例强直性脊柱炎患者,采用随机数表法分为联合组(n=75)和单药组(n=74)。单药组给予沙利度胺治疗,联合组在单药组的基础上给予艾拉莫德治疗。比较两组临床疗效、免疫球蛋白、ESR、C3、C4、肿瘤坏死因子(TNF-α)、C反应蛋白(CRP)、临床症状情况及不良反应发生情况。结果:治疗后,两组总有效率比较差异显著(P<0.05);与治疗前比较,联合组和单药组免疫球蛋白水平检验结果比较无显著差异;治疗后,联合组和单药组Ig A、Ig G及Ig M水平均随着时间的推移而下降,且联合组低于单药组,差异显著(P<0.05);与治疗前比较,联合组和单药组ESR、C3、C4水平检验结果比较无显著差异;治疗后,联合组和单药组ESR、C3及C4水平均随着时间的推移而下降,且联合组低于单药组,差异显著(P<0.05);与治疗前比较,联合组和单药组炎症因子水平检验结果比较无显著差异;治疗后,联合组和单药组TNF-α、CRP水平均随着时间的推移而下降,且联合组低于单药组,差异显著(P<0.05);与治疗前比较,联合组和单药组临床症状比较无显著差异;治疗后,联合组和单药组关节肿胀、晨僵时间均随着时间的推移而下降,且联合组低于单药组,差异显著(P<0.05);联合组与单药组患者不良反应总发生率相比,差异无统计学意义(P>0.05)。结论:在强直性脊柱炎患者中应用艾拉莫德联合沙利度胺效果显著,可有效改善患者免疫球蛋白及ESR、C3、C4水平,且不增加不良反应。

Objective:To study Effects of elamud combined with thalidomide on immunoglobulin,ESR,C3 and C4 in patients with ankylosing spondylitis.Methods:149 patients with ankylosing spondylitis treated in our hospital from November 2016 to December2019 were selected and divided into the combined group(n=75)and the single drug group(n=74)by random number table method.The monotherapy group was given thalidomide treatment,and the combination group was given Alamodern treatment on the basis of the control group.The clinical efficacy,immunoglobulin,ESR,C3,C4,tumor necrosis factor(TNF-α),C-reactive protein(CRP),clinical symptoms and adverse reactions of the two groups were compared.Results:After treatment,the total effective rate of the two groups was significantly different(P<0.05).There was no significant difference in immunoglobulin levels between the combination group and the single drug group compared with that before treatment.After treatment,Ig A,Ig G and Ig M levels in the combined group and the control group all decreased with the passage of time,and the levels in the combined group were lower than those in the control group,with significant differences(P<0.05).There was no significant difference in ESR,C3 and C4 levels between the combined group and the single drug group compared with that before treatment.After treatment,ESR,C3 and C4 levels in both the combined group and the control group decreased with the passage of time,and the levels in the combined group were lower than those in the control group,with significant differences(P<0.05).There was no significant difference in inflammatory factor levels between the combined group and the monotherapy group compared with the pre-treatment group.After treatment,the levels of TNF-αand CRP in both the combined group and the control group decreased over time,and the levels of TNF-and CRP in the combined group were lower than those in the control group,with significant differences(P<0.05).There was no significant difference in clinical symptoms between the combination group and the single drug group compared with the pre-treatment group.After treatment,the time of joint swelling and morning stiffness in the combined group and the control group decreased with the passage of time,and the difference was significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the combined group and the single drug group(P>0.05).Conclusion:In patients with ankylosing spondylitis,the application of elamodt combined with thalidomide has a significant effect,which can effectively improve the immunoglobulin and ESR,C3 and C4 levels in patients without increasing adverse reactions.