托珠单抗联合塞来昔布对中重度类风湿关节炎患者炎症反应的影响研究

Study on the effect of tocilizumab combined with celecoxib on inflammatory response in patients with moderate to severe rheumatoid arthritis

目的探讨托珠单抗联合塞来昔布对中重度类风湿关节炎患者治疗效果及炎症反应的影响。方法选取2021年1月~2023年1月某院收治的110例中重度类风湿关节炎患者为研究对象,随机分为对照组和观察组,各55例。对照组予以塞来昔布治疗,观察组在对照组基础上增加托珠单抗联合治疗。评估两组研究对象的临床疗效,风湿因子、炎症因子水平,预后效果评分及治疗安全性。结果观察组总有效率为92.73%(51/55),高于对照组的76.36%(42/55)(P<0.05)。治疗后,观察组类风湿因子(RF)、抗瓜氨酸蛋白抗体(ACPA)、抗核周因子(APF)水平低于对照组(P<0.05)。治疗后,观察组炎症因子白介素-6(IL-6)、Nod样受体蛋白3(NLRP3)、单核趋化因子-1(MCP-1)水平低于对照组(P<0.05)。治疗后,观察组临床疾病活动指数(CDAI)、视觉模拟评分(VAS)低于对照组,Lysholm评分高于对照组(P<0.05)。治疗期间观察组和对照组不良反应发生率分别为12.73%(7/55)、9.09%(5/55)(P>0.05)。结论托珠单抗联合塞来昔布对中重度类风湿关节炎患者疗效显著,可改善患者风湿因子、炎症因子水平,提升患者预后质量评分,且治疗安全性较高。

Objective To investigate the effect of tocilizumab combined with celecoxib on the therapeutic effect and inflammatory response in patients with moderate to severe rheumatoid arthritis.Methods A total of 110 patients with moderate to severe rheumatoid arthritis admitted to our hospital from January 2021 to January 2023 were randomly divided into control group and observation group,with 55 cases each.The control group was treated with celecoxib,the observation group was treated with Tozumab combination therapy on the basis of the control group.The clinical efficacy,levels of rheumatic factor and inflammatory factor,prognostic effect score,and treatment safety of the two groups were evaluated.Results The total effective rate of the observation group was 92.73%(51/55),which was higher than that of the control group was 76.36%(42/55)(P<0.05).After treatment,the levels of rheumatoid factor(RF),anti-citrullinated protein antibody(ACPA),and anti-perinuclear factor(APF)in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of inflammatory factors interleukin-6(IL-6),Nod-like receptor protein 3(NLRP3),and mononuclear chemokine-1(MCP-1)in the observation group were lower than those in the control group(P<0.05).After treatment,the clinical disease activity index(CDAI)and visual analogue score(VAS)in the observation group were lower than those in the control group,and the Lysholm score was higher than that in the control group(P<0.05).The incidence of adverse reactions in the two groups during treatment was 12.73%(7/55)and 9.09%(5/55)(P>0.05).Conclusion Tocilizumab combined with celecoxib has a significant effect on patients with moderate to severe rheumatoid arthritis,which can improve the levels of rheumatic factors and inflammatory factors,improve the prognosis quality score of patients,and have a high treatment safety.