^(99m)Tc-亚甲基二膦酸盐在类风湿关节炎的疗效及其对炎性细胞因子的抑制作用

Therapeutic effect of ^(99m)Tc-MDP and its role in proinflammatory cytokines in rheumatoid arthritis

目的探讨锝-亚甲基二膦酸盐注射液(Tc-MDP)对类风湿关节炎(rheumatoid arthritis,RA)临床表现及实验室炎性指标的抑制作用及其机制。方法以前瞻性随机开放研究,观察99mTc-MDP治疗前后RA患者临床表现、急性炎症指标以及白细胞介素(IL)-1β、肿瘤坏死因子(TNF)-α的变化。结果经99mTc-MDP治疗后,RA患者的晨僵时间、握力、压痛和肿胀关节数、关节压痛和肿胀指数、休息痛及医生对病情的估计等临床指标均有显著改善(P<0.01或0.05),血沉(ESR)、C反应蛋白(CRP)、血小板计数等炎症指标明显下降(P<0.01或0.05)。同时,血清中IL-1β、TNF-α等细胞因子水平均显著降低(P<0.05)。结论99mTc-MDP对RA的短期疗效显著,并可改善实验室活动性指标。

Objective To evaluate the effect of 99m Tc-MDP on clinical and laboratory parameters in rheumatoid arthritis(RA).Methods The study was a prospective open cohort design.Clinical manifestations were recorded accordingly before and after 99m Tc-MDP intravenous infusion.Serum CRP,IL-1β,TNF-αand ESR were also measured.Results At the end point,morning stiffness,strength,index of joint tenderness,swelling,rest pain and physician assessment were all improved significantly(P<0.01or0.05).There was also a dramatic reduction of the levels of ESR,CRP,PLT,IL-1βand TNF-α(P<0.01or0.05).Conclusion 99m Tc-MDP can remarkably improve clinical and laboratory indexes in RA in short time.It is suggested that 99m Tc-MDP is a promising agent in the treatment of RA.