糖皮质激素对类风湿关节炎炎性因子改变及效果的观察
| 作者: |
1黄楚泉,
1蔡奕,
1郑裕彬,
1郭正端
1 潮州市人民医院风湿免疫科，广东 潮州 521000 |
| 通讯: |
黄楚泉
Email: hcq790619@sina.com |
| DOI: | 10.3978/j.issn.2095-6959.2016.08.029 |
摘要
目的：分析糖皮质激素对类风湿关节炎炎性因子改变及效果。方法：选取我院2014年8月至2015年8月门诊及住院就诊的80例类风湿关节炎患者，依据抽签法分成对照组与观察组，每组40例，对照组采取常规治疗，观察组基于对照组联合糖皮质激素治疗，对比分析两组治疗后炎性因子、RF、ESR、晨僵、关节肿胀数及关节压痛数、DAS评分及VAS评分变化、治疗有效率与不良反应。结果：治疗后，观察组炎性因子TNF-α低于对照组[(31.23±8.74) vs. (36.46±9.12) pg/mL]，IL-6低于对照组[(2.62±0.31) vs. (3.67±0.36) pg/L]，CRP低于对照组[(15.26±1.03) vs. (17.38±1.10) mg/L]，比较有显著差异(P<0.05)；观察组RF低于对照组[(15.34±1.21) vs. (20.25±1.24) U/mL]，ESR低于对照组[(24.36±1.57) vs. (28.95±1.60) mm/h]，晨僵少于对照组[(16.73±1.28) vs. (18.97±1.34)]，关节肿胀数低于对照组[(47.28±0.40) vs. (6.73±0.45)]，关节压痛数低于对照组[(6.18±0.52) vs. (9.36±1.05) min]，比较差异显著(P<0.05)；观察组DAS28低于对照组[(1.93±0.20) vs. (2.18±0.26) 分]，VAS低于对照组[(2.23±0.25) vs. (3.07±0.12) 分]，比较差异明显(P<0.05)；治疗有效率95.00%高于对照组80.00%(P<0.05)，观察组总不良反应率25.00%高于对照组20.00%，但无统计学意义(P>0.05)。结论：类风湿关节炎运用糖皮质激素治疗安全性高，可有效降低炎性因子水平，改善患者临床症状，促进身心恢复。
关键词：
糖皮质激素
类风湿关节炎
炎性因子
The observed changes and the effect of inflammatory cytokines by glucocorticoid therapy in rheumatoid arthritis
CorrespondingAuthor: HUANG Chuquan Email: hcq790619@sina.com
DOI: 10.3978/j.issn.2095-6959.2016.08.029
Abstract
Objective: To analyse the changes and the effect of glucocorticoid on inflammatory cytokines in rheumatoid arthritis. Methods: Selected 80 cases of rheumatoid arthritis patients from August 2014 to August 2015 in outpatient and inpatient, divided into the observation group and control group by drawing lots, each group with 40 patients. The control group received conventional treatment, the observation group plus glucocorticoid based on the control group, compared the inflammatory factor, RF, ESR, morning stiffness, number of swollen joints and tender joint count, DAS score and VAS score changes, treatment efficiency and adverse reactions between the two groups after the treatment. Results: After treatment, the inflammatory cytokines TNF-α level in the observation group was lower than that in the control group [(31.23±8.74) vs. (36.46±9.12) pg/mL], IL-6 was lower than that in the control group [(2.62±0.31) vs. (3.67±0.36) pg/L], and CRP was lower than that in the control group [(15.26±1.03) vs. (17.38±1.10) mg/L], there was significant difference (P<0.05); the RF in the observation group was lower than that in the control group [(15.34±1.21) vs. (20.25±1.24) U/mL], ESR lower than the control group [(24.36±1.57) vs. (28.95±1.60) mm/h], morning stiffness lower than the control group [(16.73±1.28) vs. (18.97±1.34)], number of swollen joints lower than the control group [(47.28±0.40) vs. (6.73±0.45)], joint tenderness lower than the control group [(6.18±0.52) vs. (9.36±1.05) min], the difference was significant (P<0.05); the DAS28 was lower than that in the control group [(1.93±0.20) vs. (2.18±0.26) min], VAS lower than the control group [(2.23±0.25) vs. (3.07±0.12)] points, the difference was significant (P<0.05); treatment efficiency of observation group was 95.00%, higher than 80% of the control group (P<0.05), adverse reaction rates of observed group was 25.00%, higher than 20.00% of the control group, but not statistically significant (P>0.05). Conclusion: Glucocorticoid therapy on rheumatoid arthritis is safe, can effectively reduce levels of inflammatory factors, improve the clinical symptoms, and promote physical and psychological recovery.