【摘要】：目的:比較艾拉莫德分別聯(lián)合甲氨蝶呤和雙醋瑞因?qū)﹄y治性類風(fēng)濕關(guān)節(jié)炎(RRA)患者相關(guān)指標(biāo)的影響。方法:98例RRA患者隨機(jī)分為對(duì)照組(48例)和觀察組(50例)。對(duì)照組患者口服艾拉莫德片25 mg,每日2次+甲氨蝶呤片初始劑量10 mg,每周1次,2周后增加至12.5 mg,并于第2個(gè)周期加量至15 mg,每周1次。觀察組患者口服艾拉莫德片(用法用量同對(duì)照組)+雙醋瑞因膠囊50 mg,每日2次。兩組均以4周為1個(gè)周期,共治療6個(gè)周期。觀察兩組患者治療前后晨僵時(shí)間、28個(gè)關(guān)節(jié)壓痛數(shù)、28個(gè)關(guān)節(jié)腫脹數(shù)、28個(gè)關(guān)節(jié)的疾病活動(dòng)度(DAS28)評(píng)分、紅細(xì)胞沉降率(ESR)、類風(fēng)濕因子(RF)、白細(xì)胞介素1(IL-1)、血管內(nèi)皮生長(zhǎng)因子(VEGF)、腫瘤壞死因子α(TNF-α)、C反應(yīng)蛋白(CRP)、丙二醛(MDA)、超氧化物歧化酶(SOD)、總抗氧化能力(TAOC)、早期血流峰值(E峰)、左室舒張晚期血流峰值(A峰)、E/A、左室射血分?jǐn)?shù)(LVEF)及不良反應(yīng)發(fā)生情況。結(jié)果:治療后,兩組患者晨僵時(shí)間、28個(gè)關(guān)節(jié)壓痛數(shù)、28個(gè)關(guān)節(jié)腫脹數(shù)、DAS28評(píng)分、ESR、RF、IL-1、TNF-α、CRP、VEGF、MDA、TAOC、A峰均顯著低于同組治療前,且觀察組顯著低于對(duì)照組;兩組患者SOD、E峰、E/A、LVEF均顯著高于同組治療前,且觀察組顯著高于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者不良反應(yīng)發(fā)生率比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:艾拉莫德聯(lián)合雙醋瑞因治療RRA在改善患者心功能、氧化-抗氧化系統(tǒng)失衡及降低炎癥反應(yīng)作用方面均優(yōu)于艾拉莫德聯(lián)合甲氨蝶呤,而兩者安全性相當(dāng)。
[Abstract]:Objective: to compare the effects of alamod combined with methotrexate and diacetate on (RRA) patients with refractory rheumatoid arthritis. Methods: 98 patients with RRA were randomly divided into control group (n = 48) and observation group (n = 50). In the control group, the initial dose of methotrexate tablets was 10 mg, twice a day for 25 mg, increased to 12.5 mg, after 2 weeks and increased to 15 mg, once a week in the second cycle. The patients in the observation group were given Elamod tablets twice a day for 50 mg,. Both groups were treated with 4 weeks as a cycle for a total of 6 cycles. The morning stiffness time, 28 joint tenderness, 28 joint swelling, disease activity (DAS28) score, erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), IL-1 (IL-1) and vascular endothelial growth factor (VEGF), tumor necrosis factor 偽 (TNF- 偽), C reactive protein (CRP), malondialdehyde (MDA), SOD (SOD),) were observed before and after treatment. The early blood flow peak (E peak), left ventricular late diastolic blood flow peak (A peak), E 鈮，

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