摘要
目的:研究难治性类风湿关节炎(RRA)治疗中双醋瑞因与艾拉莫德联合疗效及对患者辅助性T细胞17(TH17)/调节性T淋巴细胞(Treg)的影响.方法:回顾性分析 2021 年 1 月至 2023 年12 月入院的80 例RRA患者,根据不同治法分为单一组(单用艾拉莫德,40 例)与联合组(联用艾拉莫德、双醋瑞因,40 例);比较两组治疗前后血清学指标[白细胞介素-17(IL-17)、TH17、Treg、TH17/Treg]、血清炎症因子[C-反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-1(IL-1)]、免疫学指标[免疫球蛋白 M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)]、实验室指标[人内皮抑素(ES)、类风湿因子(RF)、红细胞沉积率(ESR)]、临床症状改善状况(关节肿胀数量、晨僵时间、关节疼痛(VAS)评分)与治疗后总有效率、不良反应(白细胞减少、恶心呕吐、瘙痒、皮疹)发生率.结果:与单一组比较,联合组治疗后 IL-17、TH17、TH17/Treg、CRP、TNF-α、IL-1β、IL-1、IgM、IgA、IgG、RF、ESR与关节肿胀数量、VAS评分更低,Treg、ES 更高,晨僵时间更短,差异有统计学意义(P<0.05).联合组治疗后总有效率(97.50%)高于单一组(80.00%),差异有统计学意义(P<0.05).两组白细胞减少、恶心呕吐、瘙痒、皮疹发生率差异无统计学意义(P>0.05).结论:RRA 治疗中双醋瑞因与艾拉莫德联合疗效显著,有益于进一步改善患者炎症因子、免疫学指标及实验室指标与减轻症状,还可纠正TH17/Treg失衡,且不良反应少.
Abstract
Objective:To investigate the efficacy of diacreine combined with eramode in the treatment of refractory rheumatoid arthritis(RRA)and the effects on helper T cell 17(TH17)/regulatory T lymphocyte(Treg)in patients.Methods:A total of 80 patients with RRA admitted to hospital from January 2021 to De-cember 2023 were retrospectively analyzed and divided into single group(40 cases with eramodide alone)and combined group(40 cases with eramodide and diacerein)according to different treatment methods.Serologi-cal indexes[interleukin-17(IL-17),TH17,Treg,TH17/Treg],serum inflammatory factors[C-reactive protein(CRP),tumor necrosis factor(TNF-α),interleukin-1β(IL-1β),interleukin-1(IL-1)]and im-munological indexes were compared between the two groups before and after treatment[Immunoglobulin]M(IgM),immunoglobulin A(IgA),immunoglobulin G(IgG)〛,laboratory indicators[human endostatin(ES),rheumatoid factor(RF),erythrocyte deposition rate(ESR)],improvement of clinical symptoms(number of joint swelling,morning stiffness time,joint pain(VAS)score),total response rate and the inci-dence of adverse reactions(leukopenia,nausea and vomiting,pruritus,and rash)after treatment.Results:Compared with the single group,the combination group had lower IL-17,TH17,TH17/Treg,CRP,TNF-α,IL-1β,IL-1,IgM,IgA,IgG,RF,ESR and joint swelling number,VAS score,higher Treg and ES,and shorter morning stiffness time after treatment.The difference was statistically significant(P<0.05).The total effective rate of combination group(97.50%)was higher than that of single group(80.00%),and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of leu-kopenia,nausea and vomiting,pruritus and rash between the two groups(P>0.05).Conclusion:In the treatment of RRA,the combination of diacrein and eramod has significant efficacy,which is beneficial to fur-ther improve inflammatory factors,immunological indicators and laboratory indicators of patients and alleviate symptoms,and can also correct TH17/Treg imbalance with less adverse reactions.
基金项目
广东省科技计划(医疗卫生)项目(2020Y101)
维普
万方数据