艾拉莫德联合甲氨蝶呤对类风湿关节炎患者血清相关细胞因子及骨代谢的影响

摘要

Objective To explore the effect of lguratimod in combined with methotrexate on the serum related cytokines and bone metabolism in patients with rheumatoid arthritis (RA). Methods A total of 70 patients with RA who were admitted in our hospital from December, 2015 To November, 2016 were included in the study and randomized into the observation group and the control group. The patients in the control group were given routine treatments and MTX. On the above basis, the patients in the observation group were given iguratimod. The patients in the two groups were continuously treated for 6 months, and given comprehensive nursing interventions. The morning fasting peripheral venous blood before and after treatment was collected. ELISA was used to detect TNF-α, IL-6, COX-2, and M-CSF. The electronoluminescence immunological methods was used to detect N-MID, TPⅠNP, and β-CTX. ELISA was used to detect [25(OH)D]. SDS and SAS were used to evaluate the anxiety and depression. Results TNF-α, IL-6, IL-8, COX-2, and M-CSF levels after treatment in the observation group were significantly lower than those in the control group (P < 0.01). β-CTX level after treatment in the observation group was significantly lower than that in the control group, while TPⅠNP, N-MID, and 25(OH)D levels were significantly higher than those in the control group (P<0.01). SDS and SAS scores after treatment in the observation group were significantly lower than those in the control group (P< 0.01). Conclusion MTX in combined with iguratimod can together resist the infl ammatory reaction in patients with RA, and preferably play a better effect in the bone formation and born absorption antagonism, with a satisfactory clinical effect; therefore, it deserves to be widely recommended in the clinic.%目的 探讨艾拉莫德联合甲氨蝶呤对类风湿关节炎(RA)患者血清相关细胞因子及骨代谢的影响.方法 选取2015年12月-2016年11月收治的RA患者70例,随机分为2组,均给予常规治疗并口服甲氨蝶呤片(MTX),观察组在上述治疗的基础上口服艾拉莫德,2组连续治疗6个月,并进行综合综合干预.采集2组治疗前、后晨起空腹外周静脉血,使用ELISA法检测2组血液标本中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、环氧合酶(COX-2)、巨噬细胞集落刺激因子(M-CSF);电子发光免疫法检测骨钙素N端中分子(N-MID)、总Ⅰ型胶原氨基端延长肽(TPⅠNP)、β-胶原降解产物(β-CTX),ELISA法检测25羟维生素D[25(OH) D];依照抑郁自评量表(SDS)和焦虑自评量表(SAS)进行焦虑、抑郁评分.结果 治疗后观察组TNF-α、IL-6、IL-8、COX-2及M-CSF水平均明显低于同期对照组(P<0.01);观察组治疗后β-CTX水平低于对照组, TPⅠNP、N-MID、25(OH)D水平高于对照组(P<0.01);观察组治疗后SDS、SAS评分低于对照组(P<0.01).结论 MTX联合艾拉莫德可起到协同抵抗RA患者炎症反应,更好的发挥骨形成作用和拮抗骨吸收作用.