首页|低剂量泼尼松单用与联合甲氨蝶呤治疗风湿性多肌痛对比研究

低剂量泼尼松单用与联合甲氨蝶呤治疗风湿性多肌痛对比研究

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目的:探讨低剂量泼尼松(10 mg/d)单用治疗风湿性多肌痛(PMR)疗效及安全性.方法:收集初诊未治的PMR患者共40例,依据随机数字表法随机分为低剂量泼尼松单用组、联合甲氨蝶呤(MTX)组各20例,进行为期6个月的前瞻性随访对照研究,记录基线时及治疗6个月后的红细胞沉降率(ESR)、C反应蛋白(CRP)、晨僵时间及PMR活动指数(PMR-AS)等临床数据,比较两组间疗效及安全性.结果:两组治疗6个月后ESR、CRP、晨僵时间及PMR-AS等指标均较基线时改善(P<0.05);泼尼松组与泼尼松+MTX组治疗6个月的有效率(85.00%vs.80.00%)比较,差异无统计学意义(P>0.05);两组治疗后达到完全缓解时间[(4.14±1.78)月vs.(3.60±1.71)月]及治疗有效时间[2.00(1.00,5.00)月 vs.1.00(1.00,2.75)月]比较,差异无统计学意义(P>0.05);除空腹血糖轻度升高和肝功能损害外,两组未见有其他不良反应.结论:泼尼松10 mg/d单药治疗PMR临床有效且副作用轻微.
Comparing the efficacy of low-dose prednisone monotherapy and combined therapy with methotrexate in the treatment of polymyalgia rheumatica
Objective:To investigate the efficacy and safety of low-dose prednisone monotherapy in the treatment of polymyalgia rheumatica(PMR).Methods:Forty untreated PMR patients were included and randomly divided into low-dose prednisone monotherapy group and combined therapy with prednisone and methotrexate group(prednisone group and prednisone+MTX group,both n=20)according to the random number table method.A prospective follow-up comparative study was conducted for 6 months.The clinical data,including erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),morning stiffness time and PMR activity score,were recorded at baseline and 6 months after treatment,and the efficacy and safety were compared between two groups.Results:Compared with baseline,ESR,CRP,morning stiffness time and PMR activity score in both groups were significantly improved after 6 months of treatment(P<0.05).There was no significant difference in the 6-month effective rates(85.00%vs.80.00%),time to complete remission[(4.14±1.78)months vs.(3.60±1.71)months]and effective treatment time[2.00(1.00,5.00)months vs.1.00(1.00,2.75)months]between the two groups(all P>0.05).No other adverse reactions were observed in both groups except for mild increase in fasting blood glucose and liver function damage.Conclusion:Low-dose prednisone monotherapy is clinically effective in the treatment of PMR with mild side effects.

polymyalgia rheumaticaprednisonemethotrexate

汪筱莞、徐亮、贾兰兰、冯丹丹

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皖南医学院第一附属医院弋矶山医院 风湿免疫科,安徽 芜湖 241001

风湿性多肌痛 泼尼松 甲氨蝶呤

芜湖市科技计划皖南医学院中青年科研基金皖南医学院中青年科研基金

2020ms3-4WK2020F16WK2022F16

2024

皖南医学院学报
皖南医学院

皖南医学院学报

CSTPCD
影响因子:0.695
ISSN:1002-0217
年,卷(期):2024.43(2)