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目的探讨艾拉莫德阶段性联合甲泼尼龙和甲氨蝶呤治疗类风湿关节炎(RA)伴白细胞减少患者的临床效果。方法选取内江市第二人民医院收治的RA伴白细胞减少患者共60例为研究对象,随机分为试验组和对照组,各30例。对照组给予甲氨蝶呤片治疗,根据患者情况加减甲泼尼龙,试验组患者给予在对照组基础上加用艾拉莫德,两组疗程均为12周,比较两组患者的治疗效果。结果治疗3个月后两组患者ESR水平、CRP水平、DAS28评分较治疗前均明显降低,白细胞计数水平较治疗前增高,且试验组患者红细胞沉降率(ESR)、C反应蛋白(CRP)、疾病活动指数28(DAS28)评分均低于对照组,白细胞计数水平高于对照组,差异均有统计学意义(均P<0.05)。试验组对白细胞减少症治疗的显效率、总有效率均明显高于对照组,差异均有统计学意义(均P<0.05)。试验组患者的ACR20(86.67%)、ACR50(46.67%)、ACR80(16.67%)缓解率均明显高于对照组的ACR20(63.33%)、ACR50(20.00%)、ACR80(0.00%)缓解率,差异均有统计学意义(均P<0.05)。结论艾拉莫德阶段性联合甲泼尼龙和甲氨蝶呤治疗RA伴白细胞减少能显著提高疗效,更好的改善症状及实验室指标。
Objective To investigate the clinical efficacy of iguratimod in combination with methylprednisolone and methotrexate in the treatment of rheumatoid arthritis (RA) with leukopenia. Methods A total of 60 RA patients with RA with leukopenia who were treated in No.2 People’s Hospital of Neijiang City were selected as study subjects and randomly divided into experimental group and control group with 30 cases each. The control group was treated with methotrexate, according to the patient’s condition plus methylprednisolone, the test group was given on the basis of the control group plus iguratimod, both groups were 12 weeks treatment, the treatment effect was compared between the two groups . Results The levels of ESR, CRP and DAS28 in both groups were significantly lower than those before treatment after 3 months of treatment. The levels of leukocyte in the two groups were significantly higher than those before treatment. The ESR, C-reactive protein (CRP) Disease activity index 28 (DAS28) scores were lower than the control group, leukocyte count higher than the control group, the difference was statistically significant (P <0.05). The experimental group of leukopenia treatment markedly effective, the total effective rate was significantly higher than the control group, the difference was statistically significant (P <0.05). The remission rates of ACR20 (86.67%), ACR50 (46.67%) and ACR80 (16.67%) in the experimental group were significantly higher than that of the control group (63.33%), ACR50 (20.00%) and ACR80 The differences were statistically significant (all P <0.05). Conclusion The combination of methylprednisolone and methotrexate in the treatment of RA with leukemia can significantly improve the curative effect and improve symptoms and laboratory indexes.