托法替布联合甲氨喋呤对类风湿性关节炎金属基质蛋白酶3水平的影响

Effect of tofacitinib combined with methotrexate on the matrix metalloproteinase-3 level of rheumatoid arthritis

目的通过检测治疗前后类风湿关节炎(RA)患者血基质金属蛋白酶3(MMP-3)水平变化,探究托法替布联合甲氨喋呤在RA治疗中的疗效及对骨破坏的抑制作用。方法将我院2020年5月至2021年5月门诊及住院初诊为初发的RA患者70例,按照性别、年龄分层,然后平均随机分为托法替布联合甲氨喋呤治疗组(观察组)及雷公藤联合甲氨喋呤治疗组(对照组),每组35例。观察两组患者在治疗前,治疗后2周、4周、12周血MMP-3的水平及DAS28评分,ESR、CRP指标的变化情况。结果治疗前,两组各项指标差异均无统计学意义(P>0.05);治疗后在同一时点,两组各项指标与治疗前比较均下降,其中观察组MMP-3水平、DAS28评分、ESR、CRP等与治疗前及对照组比较,差异均有统计学意义(P<0.05)。结论托法替布联合甲氨喋呤能明显降低RA患者血清中MMP-3含量,起到缓解临床症状、抑制骨破坏的作用。

Objective To explore the efficacy and inhibiting function of tofacitinib combined with methotrexate on bone destruction of rheumatoid arthritis(RA)trough detecting the matrix metalloproteinase-3(MMP-3)level before and after the treatment.Methods Totally 70 cases of RA patients in our hospital from May 2020 to May 2021 were randomly divided into observation group(treated with tofacitinib combined with methotrexate)and control group(treated with tripterygium glucosides combined with methotrexate)after they were stratified according to sex and age,35 cases in each group.The matrix metalloproteinases-3(MMP-3)and at the DAS28 scores,erythrocyte sedimentation rate(ESR)and C-reactive proteins(CRP)were measured before treatment and at two weeks,four weeks,and twelve weeks after treatment.Results Before treatment,there was no significant differences in each index between the two groups(P>0.05).At the same time point after treatment,compared with before treatment,MMP3 level,DAS28 scores,ESR and CRP of the two group decreased,and the observation group decreased more obviously than the control group(P<0.05).Conclusion Tofacitinib combined with methotrexate can decrease the MMP-3 level,relieve clinical symptoms and inhibit the bone destructions of RA patients.