阿达木单抗治疗类风湿关节炎的疗效和安全性

Efficacy and Safety of Adalimumab in the Treatment of Rheumatoid Arthritis

目的探讨阿达木单抗在类风湿关节炎(rheumatoid arthritis,RA)治疗中的临床效果及安全性。方法选取2018年5月—2022年4月徐州矿务集团总医院收治的RA患者48例为研究对象,以随机数表法分为对照组(24例,予以甲氨蝶呤治疗)、观察组(24例,基于对照组予以阿达木单抗治疗)。对比两组治疗效果、血清水平、关节压痛与肿胀数、疼痛评分、关节活动情况及不良反应发生率。结果观察组总有效率高于对照组(91.67%vs66.67%),差异有统计学意义(χ^(2)=4.547,P<0.05)。治疗后,观察组CRP、ESR水平分别为(10.05±1.22)mg/L、(21.03±3.84)mm/h,低于对照组的(17.21±2.05)mg/L、(26.62±4.33)mm/h,差异有统计学意义(t=14.704、4.732,P<0.05)。观察组患者关节压痛数、关节肿胀数分别为(3.95±0.89)、(4.52±1.36)个,低于对照组的(9.58±2.31)、(8.97±2.46)个,差异有统计学意义(t=11.142、7.756,P<0.05)。观察组VAS评分、DAS28评分为(2.35±0.48)分、(2.30±0.28)分,低于对照组的(4.10±1.11)分、(3.87±0.42)分,差异有统计学意义(t=7.089、15.237,P<0.05)。观察组不良反应发生率低于对照组(8.33%vs 12.50%),但差异无统计学意义(P>0.05)。结论阿达木单抗治疗RA具有明显效果,能够有效改善CRP、ESR水平,缓解疼痛,控制病情进展,值得推广。

Objective To investigate the clinical effect and safety of adalimumab in the treatment of rheumatoid arthritis(RA).Methods Forty-eight patients with RA admitted to Xuzhou Mining Group General Hospital from May 2018 to April 2022 were selected as study subjects.The patients were divided into the control group(24 cases treated with methotrexate)and the observation group(24 cases treated with adalimumab based on the control group)by random number table method.The treatment effect,serum level,number of joint pressure and swelling,pain score,joint movement and incidence of adverse effects were compared between the two groups.Results the total effective rate of,the observation group was higher than the control group(91.67%vs 66.67%),and the difference was statistally significant(χ^(2)=4.547,P<0.05).After treatment,the CRP and ESR levels in the observation group were(10.05±1.22)mg/L and(21.03±3.84)mm/h,respectively,which were lower than those in the control group(17.21±2.05)mg/L and(26.62±4.33)mm/h,and the difference was statistally significant(t=14.704,4.732,P<0.05).The numbers of joint pressure pain and joint swelling in the observation group were(3.95±0.89)and(4.52±1.36),respectively,which were lower than those in the control group(9.58±2.31),(8.97±2.46),and the difference was statistally significant(t=11.142,7.756,P<0.05).The VAS score and DAS28 score of the observation group were(2.35±0.48)points and(2.30±0.28)points,which were lower than those of the control group(4.10±1.11)points and(3.87±0.42)points,and the difference was statistally significant(t=7.089,15.237,P<0.05).The incidence of adverse reactions of the observation group was lower than the control group(8.33%vs 12.50%),but the difference was not statistally significant(P>0.05).Conclusion Adalimumab has obvious effect in the treatment of RA,which can effectively improve CRP and ESR levels,relieve pain and control disease progression,and is worth promoting.