甲氨蝶呤联合托珠单抗治疗幼年特发性关节炎的效果分析

Effect Analysis of Methotrexate Combined with Tocilizumab in Treatment of Juvenile Idiopathic Arthritis

目的:探究幼托珠单抗联合甲氨蝶呤治疗幼年特发性关节炎(JIA)的应用效果。方法:选取2016年1月-2021年12月新疆儿童医院收治的50例JIA患儿,随机分为对照组(采用甲氨蝶呤治疗)和观察组(采用托珠单抗+甲氨蝶呤治疗),各25例,对比两组症状体征改善情况、实验室指标及不良反应发生率。结果:治疗后,对照组关节疼痛评分、关节活动评分、红细胞沉降率评分及关节疾病活动评分高于观察组,差异有统计学意义(P<0.05)。治疗后,对照组C反应蛋白、红细胞沉降率、免疫球蛋白G、免疫球蛋白A高于观察组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:予以JIA患儿托珠单抗联合甲氨蝶呤治疗效果显著,安全性较高,能够有效抑制患儿免疫功能,减轻患儿关节炎症状,改善各项实验室指标。

Objective:To explore the application effect of methotrexate combined with tocilizumab in treatment of juvenile idiopathic arthritis(JIA).Methods:A total of 50 children with JIA who were admitted to Xinjiang Children's Hospital from January 2016 to December 2021 were selected and randomly divided into the control group(received methotrexate treatment)and the observation group(received tocilizumab+methotrexate treatment),with 25 cases in each group.The improvement of symptoms and signs,laboratory indicators and incidence of adverse reactions were compared between the two groups.Results:After treatment,the joint pain score,joint motion score,erythrocyte sedimentation rate score and joint disease activity score in the control group were higher than those in the observation group,and the differences were statistically significant(P<0.05).After treatment,C-reactive protein,erythrocyte sedimentation rate,immunoglobulin G,and immunoglobulin A in the control group were higher than those in the observation group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Tocilizumab combined with methotrexate in children with JIA has a significant effect and high safety,and it can effectively inhibit the immune function of children,relieve the symptoms of arthritis in children,and improve various laboratory indicators.