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锝[99Tc]亚甲基二膦酸盐注射液联合DMARDs治疗晚期类风湿关节炎的临床观察
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| 篇名： | 锝[99Tc]亚甲基二膦酸盐注射液联合DMARDs治疗晚期类风湿关节炎的临床观察 |
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| 摘要： | 目的：观察锝[99Tc]亚甲基二膦酸盐注射液联合改善病情的抗风湿药物（DMARDs）治疗晚期类风湿关节炎（RA）的临床疗效及安全性。方法：将明确诊断为RA的患者106例按照随机数字表法分为治疗组和对照组，各53例。对照组患者仅给予DMARDs以及非甾体抗炎药治疗；治疗组患者在对照组基础上给予锝[99Tc]亚甲基二膦酸盐注射液（A剂每瓶5 mL，内含锝[99Tc]0.05 μg；B剂每瓶内含亚甲基二膦酸5 mg、氯化亚锡0.5 mg），取A剂和B剂各3支混合摇匀，常温放置5 min后加入0.9％氯化钠注射液100 mL中，ivgtt，qd。10 d为1个疗程，两组患者均连续治疗3个疗程。观察两组患者临床疗效及治疗前后晨僵时间、肿胀关节数、压痛关节数、红细胞沉降率（ESR）、类风湿因子（RF）、抗环瓜氨酸肽抗体（CCP）、C反应蛋白（CRP）、疾病活动性评分（DAS28）、腰椎骨密度T值，并比较两组患者体征改善时间和不良反应发生情况。 结果：治疗组患者脱落1例，52例完成研究；对照组患者脱落3例，50例完成研究。治疗组患者临床总有效率为94.2％，显著高于对照组的80.0％，差异有统计学意义（P＜0.05）。治疗前，两组患者晨僵时间、肿胀关节数、压痛关节数、ESR、RF、CCP、CRP、DAS28、腰椎骨密度T值比较，差异均无统计学意义（P＞0.05）；治疗后，两组患者上述体征及实验室检查指标均显著改善，且治疗组显著优于对照组，差异均有统计学意义（P＜0.05）。治疗组患者体征改善时间均显著短于对照组，差异有统计学意义（P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：锝[99Tc]亚甲基二膦酸盐注射液联合DMARDs治疗晚期RA疗效较好，能够快速地缓解患者体征，改善实验室检查指标，且安全性较好。 |
| ABSTRACT： | OBJECTIVE： To observe the clinical efficacy and safety of [99Tc]MDP injection combined with disease-modifying anti-rheumatic drugs （DMARDs） in the treatment of advanced rheumatoid arthritis （RA）. METHODS： 106 patients diagnosed as RA were divided into treatment group and control group according to random number table， with 53 cases in each group. Control group was only given DMARDs and non-steroidal anti-inflammatory drugs （NSAIDs）. Treatment group was additionally given [99Tc]MDP injection （A injection 5 mL containing 0.05 μg [99Tc]MDP； B injection containing MDP 5 mg， stannous chloride 0.5 mg） on the basis of control group； 3 A injections and 3 B injections were mixed and shaken well， and then added into 0.9％ Sodium chloride injection 100 mL after placing for 5 min， ivgtt， qd. A treatment course lasted for 10 d， and both groups received 3 courses of treatment. Clinical efficacies of 2 groups were observed as well as morning stiffness time， the number of swollen joint and tender joint， erythrocyte sedimentation rate （ESR）， rheumatoid factor （RF）， anti cyclic citrullinated peptide antibody （CCP）， CRP， disease activity score （DAS28） and T values of lumbar bone mineral density before and after treatment. The time of sign improvement and the occurrence of ADR were compared between 2 groups. RESULTS： In the treatment group， 1 cases were dropped off， 52 cases completed the study， 3 cases of the control group were dropped off， 50 cases completed the study. The total effective rate was 94.2％ in treatment group， which was significantly higher than 80.0％ of control group， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in morning stiffness time， the number of swollen joint and tender joint， ESR， RF， CCP， CRP， DAS28， T values of lumbar bone mineral density between 2 groups （P＞0.05）； after treatment， above signs and lab indexes of 2 groups were improved significantly， and the treatment group was significantly better than the control group， with statistical significance （P＜0.05）. The time of sign improvement in treatment group was significantly shorter than in control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： [99Tc]MDP injection combined with DMARDs is effective for advanced RA， and can relieve sign rapidly and improve lab indexes with good safety. |
| 期刊： | 2017年第28卷第2期 |
| 作者： | 田珈瑜，荣晓凤 |
| AUTHORS： | TIAN Jiayu，RONG Xiaofeng |
| 关键字： | 类风湿关节炎；锝[99Tc]亚甲基二膦酸盐注射液；改善病情的抗风湿药物 |
| KEYWORDS： | Rheumatoid arthritis； [99Tc]MDP injection； Disease-modifying anti-rheumatic drugs |
| 阅读数： | 357 次 |
| 本月下载数： | 1 次 |
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