甲氨蝶呤联合锝[^(99)Tc]亚甲基二磷酸盐注射液在类风湿关节炎患者中的应用

Application of methotrexate combined with technetium[^(99)Tc]methylene diphosphate injection in patients with rheumatoid arthritis

目的观察甲氨蝶呤联合锝[^(99)Tc]亚甲基二磷酸盐注射液(^(99)Tc-MDP)治疗类风湿关节炎的临床疗效。方法采用随机数字表法将100例类风湿关节炎患者分为MTX治疗组(基础治疗+甲氨蝶呤)和联合治疗组(基础治疗+甲氨蝶呤+^(99)Tc-MDP各50例,比较两组临床治疗效果、临床症状缓解情况、血清白细胞介素-6(IL-6)、C反应蛋白(CRP)、骨碱性磷酸酶(BAP)水平及不良反应发生率。结果联合治疗组与MTX治疗组疾病活动度等级比较差异有统计学意义,且联合治疗组总有效率高于MTX治疗组(P<0.05)。联合治疗组压痛关节数、肿胀关节数、晨僵时间、DSA28评分及血清IL-6、CRP水平均低于MTX治疗组,血清BAP水平高于MTX治疗组(P<0.05)。结论类风湿关节炎患者使用甲氨蝶呤联合^(99)Tc-MDP治疗方案,可显著提高临床疗效,安全性尚佳。

Objective To observe the clinical effect of methotrexate(MTX)combined with technetium[^(99)Tc]methylene diphosphate injection in the treatment of patients with rheumatoid arthritis.Methods One hundred patients with rheumatoid arthritis were divided into a MTX treatment group(basic treatment+methotrexate)and a combined treatment group(basic treatment+methotrexate+technetium[^(99)Tc]methylene diphosphate injection)by random number table method,50 in each group.The clinical treatment effect,clinical symptom relief,levels of serum interleukin-6(IL-6),C-reactive protein(CRP),and bone alkaline phosphatase(BAP)and the incidence of adverse reactions were observed and compared between the two groups.Results There was a statistically significant difference in the disease activity grade between the two groups(P<0.05).The total effective rate in the combined treatment group was higher than that in the MTX treatment group(P<0.05).The number of tender joints,the number of swollen joints,the time of morning stiffness,DSA28 score and serum IL-6 and CRP levels in the combined treatment group were lower than those in the MTX treatment group after treatment(P<0.05).The serum BAP level in the combined treatment group was higher than that in the MTX treatment group after treatment(P<0.05).Conclusion In patients with rheumatoid arthritis,MTX combined with technetium[^(99)Tc]methylene diphosphate injection can significantly improve the clinical efficacy and has good safety.