甲氨蝶呤联合环孢素A对类风湿性腕关节炎MRI变化的研究

Influence of joint use methotrexate and cyclosporin A on wrist of rheumatoid arthritis MRI

目的探讨甲氨蝶呤联合环孢素A对类风湿性腕关节炎MRI影像观察指标的影响及其临床价值。方法随机选择类风湿性腕关节炎患者各93例为对照组和观察组,分别给予甲氨蝶呤片和甲氨蝶呤片+环孢素A治疗12周,观察治疗前后各组腕关节MRI疗效,以滑膜炎、骨侵蚀、骨髓水肿各平均分值及毒副反应为观察指标进行对照。结果治疗前,观察组的滑膜炎平均分值、骨侵蚀平均分值和骨髓水肿平均分值分别为2.56±0.41、6.34±1.36和2.48±0.65;对照组的滑膜炎平均分值、骨侵蚀平均分值和骨髓水肿平均分值分别为2.55±0.40、6.56±1.45和2.51±0.72;两组的滑膜炎平均分值、骨侵蚀平均分值和骨髓水肿平均分值均无统计学差异(P>0.05);治疗后,观察组的滑膜炎平均分值、骨侵蚀平均分值、骨髓水肿平均分值和不良反应率分别为0.86±0.26、2.76±1.02、1.06±0.54和13.98%(13/93);对照组的滑膜炎平均分值、骨侵蚀平均分值、骨髓水肿平均分值和不良反应率分别为1.75±0.32、4.68±1.21、2.34±0.92和40.86%(38/93)。观察组的滑膜炎平均分值、骨侵蚀平均分值、骨髓水肿平均分值和不良反应率改善程度均优于对照组(P<0.05)。结论甲氨蝶呤联合环孢素A能显著改善类风湿性腕关节炎患者的MRI影像观察指标,明显的改善患者的病情,可作为类风湿性腕关节炎患者治疗的一种安全有效的方案,适合在临床上推广应用。

Objective To investigate the effect and clinical value of methotrexate and cyclosporin A on MRI imaging for wrist of rheumatoid arthritis. Methods Randomly selected patients with wrist of rheumatoid arthritis as the control group and the observation group, 93 cases in each group. Respectively given methotrexate and methotrexate + cyclosporine A for 12 weeks, observed the changes of wrist MRI before and after the treatment. Compared the average score of synovitis, bone erosion, bone marrow edema and toxicity. Results Before the treatment, in the observation group average score of synovitis, average score of bone erosion, average score of bone marrow edema were 2.56±0.41, 6.34±1.36 and 2.48±0.65, the control group were 2.55±0.40, 6.56±1.45 and 2.51±0.72, they were all not statistically different(P>0.05); After the treatment, in the observation group average score of synovitis, average score of bone erosion, average score of bone marrow edema and adverse reaction rates were 0.86±0.26, 2.76±1.02, 1.06±0.54 and 13.98%(13/93), the control group were 1.75±0.32, 4.68±1.21, 2.34±0.92 and 40.86%(38/93). The observation group’s average score and improvement rate of adverse reactions were better than the control group(P<0.05). Conclusions Methotrexate and cyclosporin A can improve MRI image in the wrist of rheumatoid arthritis, significantly improve the patient’s condition, can be a safe and effective program as wrist of rheumatoid arthritis, suitable for clinical application.