来氟米特及甲氨蝶呤对早期严重类风湿关节炎的治疗作用

【摘要】  　　目的 研究来氟米特及甲氨蝶呤联合运用对早期严重类风湿关节炎临床症状，特别是对关节损害的作用。方法 108例早期严重类风湿关节炎患者随机分为来氟米特组、来氟米特+甲氨蝶呤组及来氟米特+羟氯喹组，治疗前作相应的临床、实验室及影像学检查，以来氟米特30 mg/d，连续2天后改为20 mg/d，甲氨蝶呤10 mg/w，羟氯喹400 mg/d治疗12个月后，再评价患者临床、实验室及影像学的改变。结果 来氟米特组、来氟米特+甲氨蝶呤组及来氟米特+羟氯喹组治疗12个月后，关节疼痛数明显减少，关节肿胀亦得到明显改善，晨僵时间显著缩短，其中尤以来氟米特+甲氨蝶呤效果明显。关节侵蚀及Larsen-Dale积分在来氟米特+甲氨蝶呤组改善亦较其他两组显著。但血沉及C反应蛋白改变不显著。结论 来氟米特及甲氨蝶呤联合运用对早期类风湿关节炎的临床症状及关节损害的改善具有明显的效果［1］。

【关键词】  关节炎，类风湿；来氟米特；甲氨蝶呤；羟氯喹

    Efficacy of leflunomide and methotrexate in patients with early severe rheumatoid arthritis

    HUANG Sheng，LUO Fu-zhang，ZENG Jian，et al.The Affiliated Nanhai Hospital of Southern Medical University，Foshan 528200，China

    ［Abstract］  Objective  To study the combination therapies of leflunomide and methotrexate in patients with early severe rheumatoid arthritis.Methods  One hundred and eight patients with early severe rheumatoid arthritis were divided into three groups:leflunomide group，leflunomide and methotrexate group，leflunomide and hydroxychloroquine group.The results of clinical，laboratory and radiographic evidence were evaluated before treatment，patients were treated with leflunomide 30 mg/d for 2 days，then changed to 20 mg/d，methotreate 10 mg/week and hydroxychloroquine 400 mg/d respectively.The effects of treatment were evaluated again after 12 months.Results  After treatment for 12 months，the numbers of swollen  joints and duration of morning stiffness were improved significantly，especially in the therapies with leflunomide and methotrexate group.The similar results of the radiographic evidence were also observed in the leflunomide and methotrexate group.However，the differences between ESR and CRP were not significant in three groups.Conclusion  The combination uses of leflunomide and me

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