本文選題：來(lái)氟米特 + 潑尼松��； 參考：《中國(guó)藥房》2017年15期

【摘要】：目的:觀察來(lái)氟米特聯(lián)合潑尼松治療多發(fā)性肌炎的療效和安全性。方法:選取我院收治的98例多發(fā)性肌炎患者,按隨機(jī)數(shù)字表法分為觀察組和對(duì)照組,每組49例。對(duì)照組患者給予潑尼松片口服,初始給藥劑量為60~100 mg/d,每日3次,然后根據(jù)患者肌酸肌酶(CK)及臨床癥狀的改善情況逐漸減量至維持劑量10 mg/d,每日3次。觀察組患者在對(duì)照組治療基礎(chǔ)上加服來(lái)氟米特片10 mg,每日2次。兩組療程均為120 d。觀察兩組患者臨床療效和肌力評(píng)價(jià)情況,比較治療前后肌酶譜[包括CK、乳酸脫氫酶(LDH)、天冬氨酸轉(zhuǎn)氨酶(AST)、肌酸磷酸激酶(CPK)、丙氨酸轉(zhuǎn)氨酶(ALT)]、血清炎癥因子水平[包括白細(xì)胞介素2(IL-2)、IL-8、IL-12、腫瘤壞死因子α(TNF-α)和超敏C反應(yīng)蛋白(hs-CRP)]水平,同時(shí)記錄不良反應(yīng)發(fā)生情況。結(jié)果:治療后觀察組患者臨床總有效率(87.8%)和肌力達(dá)3級(jí)率(81.6%)均顯著高于對(duì)照組(分別為75.5%、55.1%),總不良反應(yīng)發(fā)生率顯著低于對(duì)照組(12.2%vs.22.4%),差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,兩組患者肌酶譜和血清炎癥因子水平均顯著低于同組治療前,且觀察組顯著低于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:來(lái)氟米特聯(lián)合潑尼松治療多發(fā)性肌炎療效較好,可以顯著提升患者肌力,改善肌酶譜和血清炎癥因子水平,且安全性較好。
[Abstract]:Objective: to observe the efficacy and safety of leflunomide combined with prednisone in the treatment of polymyositis. Methods: 98 patients with polymyositis were randomly divided into observation group and control group with 49 cases in each group. In the control group, prednisone tablets were given orally at an initial dose of 60 ~ 100 mg / d, 3 times a day, and then gradually reduced to 10 mg / d, 3 times a day, according to the improvement of creatine creatinase (CK) and clinical symptoms. The patients in the observation group received leflunomide 10 mg on the basis of treatment in the control group, twice a day. The course of treatment was 120 days in both groups. To observe the clinical curative effect and muscle strength evaluation of the two groups, Before and after treatment, the levels of muscle enzymes [including CK2, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), creatine phosphokinase (CPK), alanine aminotransferase (alt)], serum inflammatory factors [including interleukin-2 (IL-2) IL-8 IL-12, tumor necrosis factor- 偽 (TNF- 偽) and hypersensitive C-reactive protein (hs-CRP)] were compared. Adverse reactions were also recorded. Results: the total effective rate (87.8%) and muscle strength (81.6%) were significantly higher in the observation group than in the control group (75.5%, 55.1%), and the incidence of total adverse reactions was significantly lower than that in the control group (12.2vs.22.4%) (P0.05). After treatment, the levels of myozyme and serum inflammatory factors in the two groups were significantly lower than those in the same group before treatment, and the observation group was significantly lower than the control group, the difference was statistically significant (P0.05). Conclusion: leflunomide combined with prednisone is effective in the treatment of polymyositis.
【作者單位】： 襄陽(yáng)市中心醫(yī)院神經(jīng)內(nèi)科;湖北省南漳縣中醫(yī)院;
【分類號(hào)】：R542.21

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