英夫利昔单抗联合甲氨蝶呤对银屑病关节炎患者血清碱性磷酸酶水平的影响及疗效分析

目的:探讨英夫利昔单抗联合甲氨蝶呤银屑病对关节炎患者血清碱性磷酸酶水平的影响及治疗疗效。方法:选取我院2015年1月～2016年8月收治的银屑病关节炎患者66例,根据数字随机法将患者分为对照组及观察组,每组患者33例。对照组采用甲氨蝶呤进行治疗,初始剂量为7. 5 mg/周,逐渐加量至15～25 mg/周。观察组在对照组基础上联合英夫利昔单抗进行治疗,入组后在0、2、6、14、22、24周时间点输注英夫利昔单抗,每次剂量3 mg/kg。治疗24周后,比较两组患者临床疗效、治疗前后血清碱性磷酸酶水平变化情况及不良反应。结果:对照组患者治疗第14周、24周时分别有16例(48. 48%)、23例(69. 69%)患者达到Ps ARC、PASI50改善,明显低于观察组24例(72. 72%)、30例(90. 90%),差异具有统计学意义(χ2分别为4. 062、4. 694,P均<0. 05);对照组治疗第24周时21例(63. 63%)达到PASI70改善,16例(48. 48%)达到PASI90改善,明显低于观察组28例(84. 84%)、29例(87. 87%)(χ2分别为3. 882、11. 803,P均<0. 05);两组患者治疗后ALP水平较治疗前明显下降,其中观察组下降幅度明显优于对照组(P<0. 05);两组患者在治疗过程中均未出现严重不良反应,不良反应发生差异无统计学意义(P>0. 05)。结论:英夫利昔单抗联合甲氨蝶呤治疗银屑病关节炎临床疗效显著,可有效降低患者血清碱性磷酸酶水平,安全性高,值得推广。

Effect of infliximab combined with methotrexate on serum alkaline phosphatase levels in patients with psoriatic arthritis and its curative effect

Objective:To investigate the effect of infliximab combined with methotrexate on serum alkaline phosphatase levels in patients with psoriatic arthritis and its curative effect.Methods:66 cases with psoriatic arthritis treated in our hospital from January 2015 to August 2016 were selected.According to the random digital table,the patients were divided into the control group and the observation group with 33 cases in each group.The cases in the control group were treated with methotrexate with the initial dose of 7.5 mg/week and then gradually increased to 15-25 mg/week.The cases in the observation group were treated with infliximab on the basis of the treatment of the control group with infliximab infusion at a dose of 3 mg/kg at 0,2,6,14,22 and 24 weeks.After 24 weeks of treatment,the clinical efficacy,serum alkaline phosphatase levels and adverse reactions were compared between the two groups.Results:There were 16 cases(48.48%)and 23 cases(69.69%)achieved PsARC and PASI50 improvement at 14 weeks and 24 weeks respectively in the control group,which were significantly lower in the observation group24 cases(72.72%)and 30 cases(90.90%)]and the difference was statistically significant(χ^2=4.062,4.694,P<0.05).There were 21 cases(63.63%)achieved PASI70 improvement and 16 cases(48.48%)achieved PASI90 improvement in control group after 24 weeks of treatment,which was significantly lower than that in the observation group28 cases(84.84%)and 29 cases(87.87%)](χ^2=3.882,11.803,P<0.05).After treatment,the ALP levels in two groups were significantly decreased and the decreased degree of observation group was significantly higher than that in the control group(P<0.05).There were no serious adverse reactions in two groups during treatment.The adverse reaction rate was no statistically significant differenct between two groups(P>0.05).Conclusion:The clinical efficacy of infliximab combined with methotrexate in treatment of psoriatic arthritis is significant,which can effectively reduce serum alkaline phosphatase level with high safety.It is worthy of promotion.