甲氨蝶呤联合糖皮质激素对肉芽肿性小叶性乳腺炎的疗效及不良反应分析
Analysis of efficacy and adverse reactions of methotrexate combined with glucocorticoids in treatment of granulomatous lobular mastitis
陈斯琪 1王蕾 2邹妮倩 3邹素文4
作者信息
- 1. 增城区中医医院综合病科,广州 511300
- 2. 广东省中医院乳腺科,广州 510120
- 3. 广西国际壮医医院乳腺科,南宁 530200
- 4. 广东省妇幼保健院乳腺疾病防治中心,广州 511400
- 折叠
摘要
目的 分析甲氨蝶呤联合糖皮质激素对肉芽肿性小叶性乳腺炎(GLM)的疗效及不良反应.方法 回顾性选取2019年9月至2021年12月于广东省中医院和广东省妇幼保健院进行治疗的GLM患者99例,根据患者的治疗方案不同,将34例甲氨蝶呤联合糖皮质激素治疗患者纳入联合治疗组,65例单纯使用糖皮质激素治疗患者纳入对照组.比较两组患者炎症因子水平、治疗效果及不良反应发生率.结果 联合治疗组的总有效率97.06%(33/34),高于对照组80.00%(52/65),差异有统计学意义(χ2=4.038,P<0.05).联合治疗组和对照组治疗后C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞计数(WBC)水平[分别是(19.78±4.74)mg·L-1、(26.46±4.24)mg·L-1;(22.68±5.81)pg·mL-1、(33.52±6.22)pg·mL-1;(7.14±0.84)109·mL-1、(8.64±0.97)109·mL-1],低于治疗前[分别是(34.46±8.24)mg·L-1、(33.52±7.81)mg·L-1;(39.77±10.24)pg·mL-1、(40.13±11.05)pg·mL-1;(10.54±2.24)109·mL-1、(10.72±2.51)109·mL-1],且治疗后联合治疗组低于对照组(t=7.146、8.419、7.638,均P<0.05).联合治疗组不良反应发生率11.76%(4/34),低于对照组30.77%(20/65)(χ2=4.390,P<0.05).结论 甲氨蝶呤联合糖皮质激素治疗方案可显著缓解GLM患者的临床症状,且安全性较高,具有临床应用价值.
Abstract
Objective To investigate the efficacy and adverse reactions of methotrexate combined with glucocorticoids in the treatment of granulomatous lobular mastitis(GLM).Methods The clinical data of 99 patients with GLM treated in Guangdong Provincial Hospital of Traditional Chinese Medicine and Guangdong Maternal and Child Health Hospital from September 2019 to December 2021 were retrospectively analyzed.According to the patient's treatment plan,34 patients treated with methotrexate combined with glucocorticoids were enrolled in the combined group and 65 patients treated with glucocorticoids alone were included in the control group.The inflammatory factor levels,treatment effect and incidence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate was 97.06%(33/34)in the combined group,which was higher than that of 80.00%(52/65)in the control(χ2=4.038,P<0.05).The levels of C-reactive protein(CRP),interleukin-6(IL-6)and white blood cell count(WBC)after treatment in the combined group and the control group were((19.78±4.74)mg·L-1,(26.46±4.24)mg·L-1;(22.68±5.81)pg·mL-1,(33.52±6.22)pg·mL-1;(7.14±0.84)109·mL-1,(8.64±0.97)109·mL-1),respectively,which were lower than those before treatment((34.46±8.24)mg·L-1,(33.52±7.81)mg·L-1;(39.77±10.24)pg·mL-1,(40.13±11.05)pg·mL-1;(10.54±2.24)109·mL-1,(10.72±2.51)109·mL-1).Meanwhile,they were significantly lower in the combined group than in the control(t=7.146,8.419,7.638,all P<0.05).The incidence of adverse reactions in the combined group was 11.76%(4/34),which was lower than that of 30.77%(20/65)in the control group(χ2=4.390,P<0.05).Conclusion The treatment regimen of methotrexate combined with glucocorticoids can significantly alleviate the clinical symptoms of patients with GLM.Furthermore,it is highly safe and has clinical application value.
关键词
甲氨蝶呤/糖皮质激素/肉芽肿性小叶性乳腺炎/疗效/不良反应Key words
Methotrexate/Glucocorticoids/Granulomatous lobular mastitis/Therapeutic efficacy/Adverse reaction引用本文复制引用
出版年
2024
NETL
NSTL
万方数据