依据RF滴度及抗CCP抗体的变化评价早期联合治疗类风湿性关节炎的临床疗效

目的通过对病人随机分组对照的研究方法,对联合用药治疗RA的疗效进行观察和评价,探索治疗RA较为有效的方法,指导临床用药。方法选择滨州医学院附属医院2012年3月~2014年3月收治确诊为RA的患者80例,随机分为实验组和对照组,其中实验组41例,对照组39例。实验组同时应用2种慢作用抗风湿药及免疫抑制剂药物治疗,对照组每次服用1种慢作用抗风湿药及免疫抑制剂药物治疗,详细记录两组患者治疗及随访时的各项观察指标数据,然后将观察数据应用SAS统计软件进行统计学分析处理,将两组的ACR-20、X线改变、症状/体征、生存质量HAQ量表、RF及抗CCP抗体变化等资料进行统计学分析以评价两种治疗效果。结果发现治疗第12周时两组ACR-20的改善率相当,差异无统计学意义（P〉0.05）;但治疗第24周时两组ACR-20的改善出现了明显差异,分析显示实验组优于对照组,统计学分析两组间差异有统计学意义（P〈0.05）。两组治疗后第12周、第24周两项观察指标数据（患者对疾病的治疗效果评价及医生对患者疾病治疗的评价）进行比较分析,结果显示实验组优于对照组,两组间差异均有统计学意义（P〈0.05）。治疗后24周两组间生存质量HAQ分析的数据进行比较,结果同样显示实验组效果明显优于对照组,两组间差异均有统计学意义（P〈0.05）。结论通过本研究,证明了对于RA的两种治疗方案均有效,实验组对于RF滴度及抗CCP抗体改变优于对照组,也为临床治疗RA的联合用药提供了参考。

Evaluation on the early clinical effect of rheumatoid arthritis by RF and the changes in anti-CCP antibodies

Objective To explore the effective approach for rheumatoid arthritis treatment through a case-control study of early drug combination therapy for the treatment of RA. Methods Eighty cases participated in the ultimate test,including 41 cases in treatment group and 39 cases in control group from March 2010 to February 2014. The treatment effectiveness of the treatment group and the control group were system compared,using statistical analysis method on all treated cases were RF and anti CCP antibody changes in the effective index of observation. Results Found that ,at the twelfth treatmnet week, the ACR- 20 improvement rates of the two group are balance, there isnot significant differences（P〉0. 05） ;But at the twenty-fourth treat- ment week the ACR-20 improvement rates of the two group appeared obvious difference, and analysis showed that the test group was better than the control group, there was statistically significant difference between the two groups by statistical anal- ysis（ P〈0.05 ）. To comparative analysis the observation index data from the two groups at the twelfth and twenty-fourth treat- ment weeks （evaluating the therapeutic effect of patients and physician assessments of disease treatment）, the results showed that the test group is better than the control group, there is statistical significance of the difference between the two groups（P 〈0.05 ）. To compare with the data of analysising of quality of life in HAQ between the two groups after 24 treatment weeks, the results aslo showed that the test group is better than the control group,there is statistical significance of the difference be- tween the two groups（P〈0. 05）. Conclusion Through this research, ther two ways of the treatment of RA were proved effec- tively, the changes of the titer of RF and anti CCP antibody in the test group are better than the control group, also providing a reference for the combined treatment of RA in the clinical.