托珠单抗治疗类风湿关节炎35例

摘要

目的 探讨托珠单抗治疗类风湿关节炎(RA)的临床疗效并评价其安全性.方法 选取该院2015年3月—2016年3月风湿科收治的70例RA患者为研究对象,采用随机数表法将患者分为治疗组和对照组,每组35例.治疗组患者静脉滴注托珠单抗,8 mg·kg-1,每4周1次.对照组患者口服来氟米特片,第1~3天,50 mg·d-1;第4天至治疗结束,20 mg·d-1.两组治疗周期均为24周.比较治疗前及治疗过程中关节肿胀度、关节疼痛度、晨僵时间、红细胞沉降率(ESR)、C-反应蛋白(CRP)、重组人源化抗人白细胞介素6(IL-6)及重组人源化抗人白介细胞素8(IL-8).比较两组患者治疗总有效率.统计患者在治疗过程中出现的药品不良反应,比较药品不良反应发生率.结果 治疗后治疗组关节肿胀度、关节疼痛度、晨僵时间、ESR、CRP、IL-6及IL-8显著低于对照组(P<0.05);总有效率较对照组显著高(P<0.05);药品不良反应发生率显著低于对照组(P<0.05).结论 托珠单抗与来氟米特在RA的治疗中均有一定疗效,但托珠单抗疗效更显著,药品不良反应发生率低,具有较高的临床推广价值.%Objective To explore and compare the clinical curative effect of tocilizumab and leflunomide in the treatment of rheumatoid arthritis and to evaluate the safety. Methods From March 2015 to March 2016,70 cases of rheumatoid arthritis treated in the department of rheumatism in this hospital were divided into treatment group and control group by using a random number table method,35 cases in each group.The patients in the observation group were intravenously treated with tocilizumab,at dosage of 8 mg·kg-1,once every four weeks.The control group was treated by oral administration of leflunomide tablets,at 50 mg·d-1from the 1st to 3rd day,and at 20 mg·d-1from the fourth day to the end of the treatment.The treatment period was 24 weeks in the two groups.Joint swelling,joint pain,morning stiffness,ESR,CRP,IL-6 and IL-8 were recorded and compared before and during the treatment.Total effective rate of treatment was compared between the two groups.Adverse drug reaction was recorded and the incidence of adverse drug reactions was compared. Results After the treatment,joint swelling, joint pain,morning stiffness,ESR,CRP,IL-6 and IL-8 were significantly lower in the treatment group than those in the control group (P<0.05).After the treatment,the total effective rate of the treatment was significantly higher than that of the control group (P<0.05).After the treatment,incidence of adverse reaction was significantly lower in the treatment group than that in the control group(P<0.05). Conclusion Tocilizumab and leflunomide has certain curative effect in the treatment of rheumatoid arthritis, but tocilizumab is more effective,with low incidence of adverse reaction and a high clinical value.