托法替布联合氨甲蝶呤治疗类风湿关节炎患者的效果

Effects of Tofacitinib combined with Methotrexate in treatment of patients with rheumatoid arthritis

目的:观察托法替布联合氨甲蝶呤治疗类风湿关节炎(RA)患者的效果。方法:回顾性分析2020年5月至2023年6月该院收治的60例RA患者的临床资料,按照治疗方法不同将其分为对照组和研究组各30例。对照组采用氨甲蝶呤治疗,研究组在对照组基础上联合托法替布治疗,两组均连续治疗3个月。比较两组临床疗效,治疗前后临床症状(关节肿胀、疼痛、晨僵)评分、骨代谢指标[Ⅰ型前胶原氨基末端肽(PⅠNP)、β-胶原降解产物(β-CTX)、N端中段骨钙素(N-MID)、骨保护素(OPG)]水平、炎性指标[白细胞介素-8(IL-8)、簇集蛋白(CLU)、C反应蛋白(CRP)、壳多糖酶3样蛋白1(CHI3L1)]水平,以及不良反应发生率。结果:研究组治疗总有效率为93.33%(28/30),高于对照组的73.33%(22/30),差异有统计学意义(P<0.05);治疗后,研究组关节肿胀、疼痛、晨僵评分均低于对照组,差异有统计学意义(P<0.05);治疗后,研究组PⅠNP、N-MID、OPG水平高于对照组,β-CTX、IL-8、CRP、CHI3L1、CLU水平低于对照组,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:托法替布联合氨甲蝶呤治疗RA患者可提高治疗总有效率,改善骨代谢指标水平,降低临床症状评分和炎性指标水平,效果优于单纯氨甲蝶呤治疗。

Objective:To observe effects of Tofacitinib combined with Methotrexate in treatment of patients with rheumatoid arthritis(RA).Methods:The clinical data of 60 patients with RA admitted to this hospital from May 2020 to June 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group and study group,30 cases in each group.The control group was treated with Methotrexate,while the study group was treated with Tofacitinib on the basis of that of the control group.Both groups were treated continuously for 3 months.The clinical efficacy,the clinical symptoms(joint swelling,pain,morning stiffness)scores,the bone metabolism indexes[typeⅠcollagen carboxy-terminal propeptide(PⅠNP),β-collagen degradation product(β-CTX),N-terminal middle segment of osteocalcin(N-MID),osteoprotegerin(OPG)]levels,the inflammatory indexes[interleukin-8(IL-8),clusterin(CLU),C-reactive protein(CRP),chitinase 3-like protein 1(CHI3L1)]levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the study group was 93.33%(28/30),which was higher than 73.33%(22/30)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the scores of joint swelling,pain and morning stiffness in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of PINP,N-MID and OPG in the study group were higher than those in the control group,the levels ofβ-CTX,IL-8,CRP,CHI3L1 and CLU were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Tofacitinib combined with Methotrexate in the treatment of the RA patients can improve the total effective rate of treatment,improve the levels of bone metabolism indexes and reduce the clinical symptom scores and the inflammatory index levels.Moreover,it is superior to simple Methotrexate treatment.