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目的对比研究甲氨蝶呤和雷公藤多苷片分别联用锝[~(99)Tc]亚甲基二膦酸盐注射液和单独应用锝[~(99)Tc]亚甲基二膦酸盐注射液用于类风湿关节炎患者治疗中的临床疗效。方法选择2013年4月至2014年10月类风湿关节炎患者174例,按随机数字表法分为3组,各58例。A组患者给予锝[~(99)Tc]亚甲基二膦酸盐注射液和甲氨蝶呤(MTX),B组患者给予锝[~(99)Tc]亚甲基二膦酸盐注射液和雷公藤多苷片,C组患者给予锝[~(99)Tc]亚甲基二膦酸盐注射液,疗程均为12周。结果治疗总有效率A组(94.83%)>B组(87.93%)>C组(58.62%),差异有统计学意义(P<0.05);ACR20/50/70缓解情况,A组>B组>C组(P<0.05);A、B两组各实验室指标均较治疗前明显改善(P<0.05),一般病情、C反应蛋白、血小板计数及类风湿因子改善程度,A组>B组>C组,血沉改善程度,B组>A组>C组,且A组一般病情情况、C反应蛋白、血小板计数及类风湿因子改善程度高于B组(P<0.05),但A组血沉改善程度低于B组(P<0.05);不良反应发生率A组(18.97%)>B组(10.34%)>C组(6.90%),差异有统计学意义(P<0.05)。结论锝[99Tc]亚甲基二膦酸盐注射液联合甲氨蝶呤治疗类风湿关节炎患者的疗效可靠,缓解率高,能改善一般病情和实验室检查指标,且不良反应可控,值得临床推广。
OBJECTIVE: To compare the effects of MTX [99 Tc] methylene diphosphonate injection and MTT [~ (99) Tc] methylene diphosphonate Salt injection for the treatment of patients with rheumatoid arthritis clinical efficacy. Methods A total of 174 patients with rheumatoid arthritis from April 2013 to October 2014 were randomly divided into 3 groups (58 cases). Patients in group A were treated with technetium [~ (99) Tc] methylene diphosphonate and methotrexate (MTX) and patients in group B were injected with technetium [~ (99) Tc] methylene diphosphonate Liquid and tripterygium glycosides tablets, C group patients given technetium [~ (99) Tc] methylene diphosphonate injection, the course of treatment were 12 weeks. Results The total effective rate of treatment group A (94.83%)> B group (87.93%)> C group (58.62%), the difference was statistically significant (P <0.05); ACR20 / 50 / (P <0.05). The laboratory indexes in groups A and B were significantly improved (P <0.05), the general condition, C-reactive protein, platelet count and the improvement of rheumatoid factor in group A and group B Group C, ESR, Group B> Group A> Group C, and the general condition, C-reactive protein, platelet count and rheumatoid factor in group A were better than those in group B (P <0.05) The improvement of erythrocyte sedimentation rate was lower than that of group B (P <0.05). The incidence of adverse reactions was significantly higher in group A (18.97%) than group B (10.34%) and group C (6.90%) (P <0.05). Conclusions TcnT [99Tc] methylene diphosphonate injection combined with methotrexate in patients with rheumatoid arthritis has reliable curative effect, high remission rate, improved general condition and laboratory tests, and the adverse reactions are controllable, worthwhile Clinical promotion.