不同剂量托法替布联合甲氨蝶呤治疗类风湿性关节炎对免疫功能、类风湿因子的影响

Effects of Different Doses of Tofacatib Combined with Methotrexate on Immune Function and Rheumatoid Factors in the Treatment of Rheumatoid Arthritis

目的分析不同剂量托法替布联合甲氨蝶呤治疗类风湿性关节炎对免疫功能、类风湿因子的影响。方法回顾性选取2023年1—12月昭通市第一人民医院收治的97例类风湿性关节炎患者的临床资料,均采用托法替布联合甲氨蝶呤治疗。按照托法替布剂量不同分为小剂量组(n=45)和大剂量组(n=52)。比较两组关节运动功能、免疫功能、红细胞沉降率(ery throcyte sedimentation rate,ESR)、类风湿因子(rheumatoid factor,RF)、C-反应蛋白(C-reaction protein,CRP)、安全性。结果治疗后,大剂量组步行20 m时间、晨僵时间、双手握力以及CD3+、CD4+、CD8+水平优于小剂量组,差异有统计学意义(P均<0.05)。治疗后,大剂量组ESR为(21.50±4.29)mm/h、RF为(90.47±9.28)U/mL、CRP为(22.15±4.36)mg/L,均低于小剂量组的(25.39±4.45)mm/h、(98.46±10.45)U/mL、(26.43±4.42)mg/L,差异有统计学意义(t=4.377、3.988、4.791,P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论采用大剂量托法替布联合甲氨蝶呤治疗类风湿性关节炎能够有效改善关节运动功能、免疫功能,降低RF水平,减轻炎症反应,且不增加不良反应,整体疗效确切。

Objective To analyze the effects of different doses of tofacitib combined with methotrexate in the treatment of rheumatoid arthritis on immune function and rheumatoid factors.Methods The clinical data of 97 patients with rheumatoid arthritis admitted to the First People's Hospital of Zhaotong from January to December 2023 were retrospectively selected.All patients were treated with tofacitinib combined with methotrexate.According to the different doses of tofacitinib,they were divided into low-dose group(n=45)and high-dose group(n=52).The joint motor function,immune function,erythrocyte sedimentation rate(ESR),rheumatoid factor(RF),C-reaction protein(CRP)and safety were compared between the two groups.Results After treatment,the time of walking for 20 m,time of morning stiffness,grip strength of both hands and the levels of CD3+,CD4+and CD8+in the high-dose group were better than those in the low-dose group,and the differences were statistically significant(all P<0.05).After treatment,ESR,RF and CRP in the high-dose group were(21.50±4.29)mm/h,(90.47±9.28)U/mL and(22.15±4.36)mg/L,which were lower than(25.39±4.45)mm/h,(98.46±10.45)U/mL and(26.43±4.42)mg/L in the low-dose group,and the differences were statistically significant(t=4.377,3.988,4.791,all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion High-dose tofacitib combined with methotrexate in the treatment of rheumatoid arthritis can effectively improve joint motor function and immune function,reduce RF level,alleviate inflammatory response,and do not increase adverse reactions,the overall effect is accurate.