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华西医学  2015 

小剂量甲泼尼龙联合羟氯喹、甲氨蝶呤治疗类风湿关节炎的疗效观察

DOI: 10.7507/1002-0179.20150572, PP. 2001-2004

Keywords: 甲泼尼龙,羟氯喹,甲氨蝶呤,类风湿关节炎

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Abstract:

目的?观察小剂量甲泼尼龙联合羟氯喹、甲氨蝶呤治疗类风湿关节炎(RA)的疗效。方法?2011年1月-2013年5月将60例病程≤2年的初治RA患者随机分为对照组和治疗1组,两组各30例;两组均给予羟氯喹、甲氨蝶呤治疗,对照组加用美洛昔康(7.5mg/次,2次/d),治疗1组加用甲泼尼龙(4mg/次,2次/d)。另选30例病程≥5年的未曾规范治疗的RA患者为治疗2组,采用和治疗1组同样的治疗方案。所有患者在治疗后1周评估临床症状控制情况,治疗前和治疗后12周均评估临床指标和检测免疫学指标。结果?治疗1组和治疗2组临床症状在1周内迅速缓解,疗效较对照组明显(P<0.05);12周后治疗1组和治疗2组在临床症状、28个关节疾病活动指数评分等方面较治疗前明显改善(P<0.05);治疗1组与治疗2组相比临床症状及免疫学检查方面改善更明显。结论?小剂量甲泼尼龙联合羟氯喹、甲氨蝶呤可快速有效缓解RA患者的临床症状,病史短者疗效更好。

References

[1]  14 邓雪蓉, 周炜, 王昱, 等. 类风湿关节炎在不同治疗方案下的达标情况及影响因素分析[J]. 中华风湿病学杂志, 2014, 18(6): 365-368.
[2]  15 Wevers-De Boer K, Visser K, Heimans L, et al. Remission induction therapy with methotrexate and prednisone in patients with early rheumatoid and undifferentiated arthritis (the IMPROVED study)[J]. Ann Rheum Dis, 2012, 71(9): 1472-1477.
[3]  16 江敏, 张徐明. 不同剂量激素治疗类风湿关节炎疗效的比较研 究[J]. 临床合理用药杂志, 2013, 6(18): 20-21.
[4]  17 Da Silva JA, Jacobs JW, Kirwan JR, et al. Safety of low dose glucocorticoid treatment in rheumatoid arthritis: published evidence and prospective trial data[J]. Ann Rheum Dis, 2006, 65(3): 285-293.
[5]  18 García-Gómez C, Nolla JM, Valverde J, et al. High HDL-cholesterol in women with rheumatoid arthritis on low-dose glucocorticoid therapy[J]. Eur J Clin Invest, 2008, 38(9): 686-692.
[6]  1 Gorter SL, Bijlsma JW, Cutolo M, et al. Current evidence for the management of rheumatoid arthritis with glucocorticoids: a systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis[J]. Ann Rheum Dis, 2010, 69(6): 1010-1014.
[7]  2 Smolen JS, Landewé R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs[J]. Ann Rheum Dis, 2010, 69(6): 964-975.
[8]  3 Smolen JS, Aletaba D, Keystone E. Superior efficacy of combination therapy for rheumatoid arthritis: fact or fiction [J]. Arthritis Rheum, 2005, 52(10): 2975-2983.
[9]  4 Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allaart CF, et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): a randomized, controlled trial[J]. Arthritis Rheum, 2005, 52(11): 3381-3390.
[10]  5 林进, 徐丹怡. ACR/EULAR 2009年类风湿性关节炎新分类标准解读[J]. 浙江医学, 2010, 32(7): 985-987.
[11]  6 中华医学会风湿病学分会. 类风湿关节炎诊断及治疗指南[J]. 中华风湿病学杂志, 2010, 14(4): 265-269.
[12]  7 Van Dongen H, Van Aken J, Lard LR, et al. Efficacy of methotrexate treatment in patients with probable rheumatoid arthritis: a double-blind, randomized, placebo-controlled trial[J]. Arthritis Rheum, 2007, 56(5): 1424-1432.
[13]  8 李小峰, 张莉芸, 牛红青, 等. 甲氨蝶呤联合环磷酰胺治疗类风湿关节炎随机单盲对照临床研究[J]. 中华风湿病学杂志, 2010, 14(2): 111-114.
[14]  9 夏光涛, 许菁, 付敏, 等. 硫酸羟氯喹治疗风湿病的疗效评价[J]. 世界临床药物, 2010, 31(8): 466-468.
[15]  10 Huisman AM, Van Everdingen AA, Wenting MJ, et al. Glucocorticoid receptor downregulation in early diagnosed rheumatoid arthritis[J]. Ann N Y Acad Sci, 2002, 966: 64-67.
[16]  11 Malysheva O, Baerwald CG. Low-dose corticosteroids and disease-modifying drugs in patients with rheumatoid arthritis[J]. Clin Exp Rheumatol, 2011, 29(5, 68): S113-S115.
[17]  12 刘冬梅, 薛红霞, 杨丽丽, 等. 小剂量糖皮质激素联合DMARD治疗类风湿关节炎的临床研究[J]. 实用药物与临床, 2012, 15(4): 244-245.
[18]  13 林恒钊. 柳氮磺吡啶联合甲氨蝶呤及小剂量泼尼松治疗类风湿关节炎42例疗效观察[J]. 河北医学, 2012, 18(7): 932-934.

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