重组人Ⅱ型肿瘤坏死因子受体—抗体融合蛋白治疗类风湿关节炎的临床效果

Clinical effect of recombinant human tumor necrosis factor receptor-antibody fusion protein typeⅡin the treatment of rheumatoid arthritis

目的 观察重组人Ⅱ型肿瘤坏死因子受体—抗体融合蛋白治疗类风湿关节炎的临床效果及对血清相关指标的影响。方法 选取2020年3月—2022年7月龙岩市第二医院血液风湿科收治的类风湿关节炎患者98例,依据随机抽签法分为联合抗风湿组和常规抗风湿组,每组49例。常规抗风湿组采取常规抗风湿治疗,联合抗风湿组在常规抗风湿组基础上使用注射用重组人Ⅱ型肿瘤坏死因子受体—抗体融合蛋白治疗,2组均持续治疗6个月。比较2组患者临床疗效,治疗前后症状改善情况、血清类风湿炎性指标[C反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF)、白介素-6(IL-6)],不良反应。结果 联合抗风湿组治疗总有效率为95.92%,高于常规抗风湿组81.63%(χ^(2)=5.018,P=0.025)。治疗6个月后,2组晨僵时间较治疗前缩短,压痛指数评分、疼痛指数评分较治疗前降低,且联合抗风湿组短/低于常规抗风湿组(P均<0.01);2组CRP、RF、IL-6水平较治疗前下降,ESR较治疗前缩小,且联合抗风湿组低/小于常规抗风湿组(P均<0.01)。联合抗风湿组不良反应总发生率为4.08%,低于常规抗风湿组的18.37%(χ^(2)=5.018,P=0.025)。结论 常规抗风湿治疗基础上采用重组人Ⅱ型肿瘤坏死因子受体—抗体融合蛋白治疗类风湿关节炎的疗效显著,利于临床症状、血清指标的改善,降低炎性因子水平及减少不良反应发生,促进病症好转。

Objective To observe the effect of recombinant human tumor necrosis factor receptor-antibody fusion protein typeⅡin the treatment of rheumatoid arthritis and its effect on serum related indexes.Methods A total of 98 patients with rheumatoid arthritis admitted to the Second Hospital of Longyan from March 2020 to July 2022 were selected and divided into an combined with anti-rheumatism group and a conventional anti-rheumatism group according to random lottery method,49 cases in each group.The conventional anti-rheumatism group received conventional anti-rheumatoid therapy,and the combined with anti-rheumatism group was treated with recombinant human tumor necrosis factor receptor-antibody fusion protein typeⅡfor injection on the basis of the conventional anti-rheumatism group.The clinical efficacy,symptom improvement,serum rheumatoid inflammatory indicators(CRP,ESR,RF,IL-6)before and after treatment,and adverse reactions between the two groups were compared.Results The total effective rate of the combined with anti-rheumatism group was 95.92%,which was higher than 81.63%of the conventional anti-rheumatism group(χ^(2)=5.018,P=0.025).After 6 months of treatment,the morning stiffness duration in the two groups were shorter than those before treatment,the tenderness index score and pain index score were lower than those before treatment,and the combined with anti-rheumatism group was shorter/lower than the conventional anti-rheumatism group(P<0.01);The levels of CRP,RF and IL-6 in the two groups were lower than those before treatment,the ESR was smaller than that before treatment,and the combined with anti-rheumatism group was lower/smaller than that of the conventional anti-rheumatism group(P<0.01).The total incidence of adverse reactions in the combined with anti-rheumatism group was 4.08%,which was lower than 18.37%in the conventional anti-rheumatism group(χ^(2)=5.018,P=0.025).Conclusion On the basis of conventional anti-rheumatic therapy,the use of recombinant human tumor necrosis factor receptor-antibody fusion protein typeⅡin the treatment of rheumatoid arthritis has significant curative effect,which is conducive to the improvement of clinical symptom and serum indicators,reducing the level of inflammatory factors and the occurrence of adverse reactions,and promoting the improvement of the disease.