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目的:探讨甲氨蝶呤联合肿瘤坏死因子拮抗剂治疗类风关节炎的临床效果及安全性。方法:选取我院63例确诊为类风湿关节炎的患者,男性24例,女性39例,接受甲氨蝶呤(12.5mg,口服,每周1次),联合依那西普(益赛普,50 mg,皮下注射,每周1次),治疗12周。观察12周后患者关节肿胀疼痛、患者评价、医师评价、C反应蛋白(CRP)、血沉(ESR)等临床指标改善情况及药物不良反应。结果:治疗2周后患者有不同程度的缓解,4周后80%的患者达到临床ACR20缓解,8周后50%的患者达到了临床ACR70缓解;甲氨蝶呤联合肿瘤坏死因子拮抗剂治疗的患者在疼痛程度、关节肿胀数、BASDAI以及C反应蛋白(CRP)等临床指标上有明显改善,结果具有统计学意义(P<0.05)。结论:甲氨蝶呤联合依那西普(益赛普)治疗类风湿关节炎的短期疗效好,耐受性好,可用于类风湿关节炎的症状缓解和病因治疗。
Objective: To investigate the clinical effect and safety of methotrexate combined with tumor necrosis factor antagonist in the treatment of rheumatoid arthritis. Methods: A total of 63 patients diagnosed as rheumatoid arthritis were selected from our hospital. There were 24 males and 39 females, receiving methotrexate (12.5 mg orally once a week), etanercept , 50 mg, subcutaneously once a week) for 12 weeks. Patients were observed after 12 weeks of joint swelling pain, patient evaluation, physician evaluation, C-reactive protein (CRP), ESR and other clinical indicators to improve the situation and adverse drug reactions. Results: After 2 weeks of treatment, patients had different degrees of remission. After 4 weeks, 80% of patients achieved clinical ACR20 remission. After 8 weeks, 50% of patients achieved clinical ACR70 remission. Methotrexate combined with tumor necrosis factor antagonist The patients showed significant improvement in clinical symptoms such as degree of pain, number of swollen joints, BASDAI and C-reactive protein (CRP), with statistical significance (P <0.05). Conclusion: Methotrexate combined with etanercept (Isep) in the treatment of rheumatoid arthritis has good short-term curative effect and good tolerance. It can be used for the treatment of rheumatoid arthritis symptoms and etiology.