锝[^(99)Tc]亚甲基二膦酸盐注射液联合甲氨蝶呤及硫酸羟氯喹治疗对类风湿性关节炎患者红细胞沉降率及类风湿因子的影响

Effect of Technetium[^(99)Tc]Methylenediphosphonate Injection Combined with Methotrexate and Hydroxychloroquine Sulfate on Erythrocyte Sedimentation Rate and Rheumatoid Factor in Patients with Rheumatoid Arthritis

目的:探究锝[^(99)Tc]亚甲基二膦酸盐注射液联合甲氨蝶呤及硫酸羟氯喹治疗对类风湿性关节炎(RA)患者红细胞沉降率(ESR)及类风湿因子(RF)的影响。方法:选取2021年4月—2022年5月抚州市立医院收治的RA患者66例,选用随机数字表法分为两组,各33例。对照组接受甲氨蝶呤及硫酸羟氯喹治疗,观察组接受锝[^(99)Tc]亚甲基二膦酸盐注射液联合甲氨蝶呤及硫酸羟氯喹治疗,两组均持续治疗3个月。对比两组临床疗效、炎症因子水平、ESR及RF、类风湿关节炎活动度(DAS28)评分、症状改善情况、视觉模拟评分法(VAS)评分、不良反应。结果:观察组临床总有效率为96.97%(32/33),高于对照组的75.76%(25/33),差异有统计学意义(P<0.05);治疗后,观察组白介素-6(IL-6)(3.52±0.47)pg/mL,肿瘤坏死因子-α(TNF-α)(3.91±1.02)pg/mL,C蛋白反应(CRP)(12.33±5.15)mg/L,RF(31.62±15.16)IU/mL,ESR(25.89±10.69)mm/h,均低于对照组的(8.03±1.02)pg/mL、(7.94±2.54)pg/mL、(16.38±6.41)mg/L、(42.98±16.87)IU/mL、(35.92±11.84)mm/h,关节肿胀数目(2.01±0.45)个,关节压痛数目(4.15±1.31)个,均少于对照组的(4.05±1.56)、(6.14±2.02)个,僵硬时间(25.56±9.13)min,短于对照组的(32.85±11.85)min,双手平均握力(12.03±2.91)kPa,高于对照组的(9.51±1.05)kPa,DAS28评分(2.02±0.74)分,VAS评分(2.12±0.29)分,均低于对照组的(4.38±1.29)、(4.15±0.57)分,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:锝[^(99)Tc]亚甲基二膦酸盐注射液联合甲氨蝶呤及硫酸羟氯喹在RA患者中应用效果较佳,能够减轻炎症反应,改善临床症状及关节活动度,减轻疼痛,且未增加不良反应。

Objective:To explore the effect of Technetium[^(99)Tc]Methylenediphosphonate Injection combined with Methotrexate and Hydroxychloroquine Sulfate on erythrocyte sedimentation rate(ESR)and rheumatoid factor (RF) in patients with rheumatoid arthritis (RA). Method: A total of 66 RA patients treated in Fuzhou Municipal Hospital from April 2021 to May 2022 were selected and randomly divided into two groups, with 33 patients in each group. The control group was treated with Methotrexate and Hydroxychloroquine Sulfate, and the observation group was treated with Technetium [^(99)Tc] Methylenediphosphonate Injection combined with Methotrexate and Hydroxychloroquine Sulfate. Both groups continued to receive treatment for 3 months. The clinical efficacy, ESR and RF, inflammatory factor levels, rheumatoid arthritis activity (DAS28) score, symptom improvement, visual analogue scale (VAS) score, and adverse reactions in two groups were compared. Result: The total clinical effective rate in the observation group was 96.97% (32/33), which was higher than 75.76% (25/33) in the control group, with statistical difference (P<0.05). After treatment, interleukin-6 (IL-6) (3.52±0.47) pg/mL, tumor necrosis factor-α (TNF-α) (3.91±1.02) pg/mL, C reactive protein (CRP) (12.33±5.15) mg/L, RF (31.62±15.16) IU/mL, ESR (25.89±10.69) mm/h in the observation group, which were all lower than (8.03±1.02) pg/mL, (7.94±2.54) pg/mL, (16.38±6.41) mg/L, (42.98±16.87) IU/mL, (35.92±11.84) mm/h in the control group, joint swelling number (2.01±0.45), joint tenderness number (4.15±1.31), which were less than (4.05±1.56) and (6.14±2.02) in the control group, stiffness time (25.56±9.13) minutes in the observation group, which was shorter than (32.85±11.85) minutes in the control group, average grip strength of both hands (12.03±2.91) kPa in the observation group, which was higher than (9.51±1.05) kPa in the control group, DAS28 score (2.02±0.74) points, VAS score (2.12±0.29) points in the observation group, which were lower than (4.38±1.29) and (4.15±0.57) points in the control group, with statistically significant differences (P<0.05). The comparison of incidence of adverse reactions in two groups was not statistical different (P>0.05). Conclusion: Technetium [^(99)Tc] Methylenediphosphonate Injection combined with Methotrexate and Hydroxychloroquine Sulfate has a better effect in RA patients, which can reduce inflammatory factor levels, improve clinical symptoms and joint range of motion, alleviate pain, and there is no increase in adverse reactions.