Abstract:

Objective　To explore the therapeutic effects of tofetib combined with methotrexate, recombinant human tumor necrosis factor receptor Ⅱ IgG Fc fusion protein for injection combined with methotrexate, and methotrexate in the treatment of rheumatoid arthritis (RA). Methods　Ninety RA patients treated in Jilin Provincial People's Hospital from January 2020 to January 2022 were divided into groups A, B, and C by the random number table method, with 30 cases in each group. In group A, there were 18 males and 12 females; they were (60.06±4.27)years old. In group B, there were 16 males and 14 females; they were (60.25±4.33) years old. In group C, there were 18 males and 12 females; they were (59.43±4.06) years old. Group A were treated with methotrexat, group B with tropinib and methotrexate, and group C with recombinant human tumor necrosis factor receptor Ⅱ IgG Fc fusion protein and methotrexate, for 24 consecutive weeks. The clinical efficacies, clinical symptoms and laboratory indicators before and after the treatment, and adverse reactions of the three groups were compared. χ², t, and F tests were applied. Results　The total effective rate of group B was 93.33% (28/30), higher than those of groups C [83.33% (25/30)] and A [66.67% (20/30)], with a statistical difference (P<0.05). The morning stiffness times, joint tenderness numbers, and joint swelling numbers 8 and 24 weeks after the treatment in group B were lower than those before the treatment, and were lower than those in groups C and A (all P<0.05). The levels of erythrocyte sedimentation rate (ESR), rheumatoid factors (RF), and C-reactive protein (CRP) 8 and 24 weeks after the treatment in group B were lower than those in groups C and A (all P<0.05). The incidence of adverse reactions in group B was 6.67% (2/30), which was lower than those in groups C [13.33% (4/30)] and A [20.00% (6/30)], with no statistical difference between the three groups (P>0.05). Conclusions　Tofatib combined with methotrexate in the treatment of patients with RA can effectively improve their clinical symptoms and inhibit the indicators of disease activity. The clinical efficacy is better than that of methotrexate alone and recombinant human tumor necrosis factor receptor Ⅱ IgG Fc fusion protein combined with methotrexate, and the safety is good.

Key words:

Rheumatoid arthritis, Tofatib, Methotrexate, Efficacy, Security

摘要：

目的　探讨托法替布联合甲氨蝶呤、注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白联合甲氨蝶呤及甲氨蝶呤单药治疗类风湿关节炎（RA）的疗效。方法　选取2020年1月至2022年1月吉林省人民医院收治的RA患者90例，采用随机数字表法分为3组，各30例。A组男18例，女12例，年龄（60.06±4.27）岁，单用甲氨蝶呤治疗；B组男16例，女14例，年龄（60.25±4.33）岁，采用托法替布联合甲氨蝶呤治疗；C组男18例，女12例，年龄（59.43±4.06）岁，采用注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白联合甲氨蝶呤治疗，均连续治疗24周。比较3组患者的临床疗效、治疗前后临床症状与实验室指标水平、不良反应发生情况。采用χ²检验、t检验、F检验进行统计比较。结果　B组患者治疗总有效率为93.33%（28/30），高于C组的83.33%（25/30）和A组的66.67%（20/30），差异有统计学意义（P<0.05）。治疗后8周、24周3组患者晨僵时间、关节压痛数、关节肿胀数较治疗前均呈下降趋势，且B组晨僵时间、关节压痛数、关节肿胀数均低于C组和A组（均P<0.05）。治疗后8周、24周3组患者红细胞沉降率（ESR）、类风湿因子（RF）、C反应蛋白（CRP）水平较治疗前均呈下降趋势，且B组均低于C组和A组（均P<0.05）。B组患者不良反应发生率为6.67%（2/30），低于C组的13.33%（4/30）和A组的20.00%（6/30），但3组间比较差异无统计学意义（P>0.05）。结论　托法替布联合甲氨蝶呤治疗RA可有效改善患者临床症状，抑制病情活动指标，临床疗效优于单用甲氨蝶呤和注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白联合甲氨蝶呤治疗，且安全性良好。

关键词:

类风湿关节炎, 托法替布, 甲氨蝶呤, 疗效, 安全性