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目的:观察依那西普联合甲氨蝶呤治疗类风湿关节炎(RA)的疗效。方法:62例RA患者随机分为观察组和对照组,每组31例。对照组口服甲氨蝶呤片10mg,每周1次,观察组在此基础上皮下注射依那西普25mg,2次/周,疗程均为12周。比较两组患者治疗前后血清肿瘤坏死因子配体相关分子-1A(TL1A)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及白介素-17(IL-17)水平,以及晨僵时间、关节肿胀、压痛、疼痛评分变化,评价两组临床疗效和药品不良反应。结果:治疗后,两组患者血清TL1A、TNF-α、IL-6及IL-17水平均较前明显降低(P<0.05),且观察组明显低于对照组(P<0.05)。两组患者晨僵时间均明显缩短,关节肿胀、压痛、疼痛积分均显著降低(P<0.05);且观察组各项指标均明显优于对照组(P<0.05)。观察组总有效率明显高于对照组(P<0.05),两组药品不良反应发生率差异无统计学意义(P>0.05)。结论:RA患者采取依那西普联合甲氨蝶呤进行治疗,能降低血清TL1A、TNF-α、IL-6及IL-17水平,关节肿胀、压痛、疼痛症状可得到显著性缓解,安全性较好。
Objective: To observe the efficacy of etanercept and methotrexate in the treatment of rheumatoid arthritis (RA). Methods: Sixty-two RA patients were randomly divided into observation group and control group, 31 cases in each group. Control group oral methotrexate tablets 10mg, once a week, the observation group on the basis of subcutaneous injection of etanercept 25mg, 2 times / week, the course of treatment were 12 weeks. The levels of TLR1, TNF-α, IL-6 and IL-17 in serum of two groups were compared before and after treatment. As well as the morning stiffness time, joint swelling, tenderness, pain score changes, evaluation of two groups of clinical efficacy and adverse drug reactions. Results: After treatment, the levels of serum TL1A, TNF-α, IL-6 and IL-17 in the two groups were significantly lower than those in the control group (P <0.05), and the levels in the observation group were significantly lower than those in the control group (P <0.05). The duration of morning stiffness was significantly shortened in both groups, and the swelling, tenderness and pain scores of joints were significantly decreased (P <0.05). The indexes in the observation group were significantly better than those in the control group (P <0.05). The total effective rate in the observation group was significantly higher than that in the control group (P <0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups (P> 0.05). Conclusion: Etanercept combined with methotrexate can reduce the level of serum TL1A, TNF-α, IL-6 and IL-17 in RA patients. The symptoms of joint swelling, tenderness and pain can be significantly relieved and safety better.