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沙利度胺联合甲氨蝶呤治疗类风湿性关节炎的疗效观察
作者:张育  何斌  李国青  周玮  高娜  高波  顾健  
单位:扬州大学临床医学院  江苏省苏北人民医院血液风湿科 
关键词:类风湿性关节炎  沙利度胺  甲氨蝶呤 
分类号:
出版年,卷(期):页码:2007,2(11):641-642
摘要:

目的探讨沙利度胺单独及联合甲氨蝶呤治疗类风湿性关节炎的疗效及安全性。方法54例类风湿性关节炎(RA)患者随机分成2组,沙利度胺组20例,沙利度胺+甲氨蝶呤组34例,持续治疗3个月;每月复查疼痛关节数、肿胀关节数及晨僵出现率等临床指标及血沉和C-反应蛋白等实验室指标,所有病例随访3~8个月。结果沙利度胺组的总有效率为60%,沙利度胺+甲氨蝶呤组的总有效率为82.35%,2组之间无统计学意义;治疗前后2组各项指标比较均有统计学意义(P<0.01),治疗后2组各项指标中仅疼痛关节数有统计学意义(P<0.01);2组分别有45%和67.41%的患者有药物不良反应,但无统计学意义,症状均比较轻微,可以耐受。结论两种方案对类风湿性关节炎均有效,甲氨蝶呤与沙利度胺有协同作用,且安全性较高。

Objective To discuss Thalidomide (THD) and THD+methotrexate (MTX) on were clinical efficacy and security in the treatment of Rheumatoid arthritis (RA).Methods 54 cases of RA sufferers divided into two groups randomy:20 cases in THD group and 34 cases in THD+MTX group.The course of all groups was 3 months at least.Numbers of pain joint and swell joint,morning stiffness,erythrocyte sedimentation rate (ESR),C- reactive protein (CRP) were observed every month.Follow-up time was 3~8months.Results The effective rates of THD group and THD+MTX group were respectively 60% and 82.35%,there was no significant difference between THD group and THD+MTX group (P>0.05).Number of pain joint and swell joint,morning stiffness, ESR and CRP were improved significantly (P<0.01).There was significant difference between THD group and THD+MTX group only in number of pain joint after treatment (P<0.01).The occurrence of side effect was respectively 45% and 64.71%,with no severe side effect.Conclusion THD has efficacy and high security in treating RA,and there is synergistic action in THD and MTX. 

基金项目:
江苏省科技厅资助课题(BS2005037)
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