依那西普和英夫利昔单抗治疗青少年强直性脊柱炎的临床疗效和安全性评价

目的：比较依那西普与英夫利昔单抗治疗青少年强直性脊柱炎（AS）的临床疗效和安全性，为指导临床用药提供参考依据。方法：选取本院收治的青少年AS男性患者60例作为研究对象，随机分为依那西普组和英夫利昔单抗组，每组30例，所有患者在接受治疗前半年内及治疗期间均未曾服用改善病情的抗风湿药物（DMARDS），治疗12和24周后对2组患者进行随访，收集患者的枕墙距、指地距、Schöber试验、AS活动指数（BASDIA）、AS功能指数（BASFI）、C反应蛋白（CRP）水平、血沉（ESR）和MRI表现等指标，并进行统计学分析，评估2种药物的临床疗效，同时记录患者不良反应发生情况。结果：经24周治疗后，依那西普和英夫利昔单抗均对AS有较好的疗效，2组患者腰背部及腰骶部疼痛均明显减轻或消失，临床总有效率分别为96%和93%，组间比较差异无统计学意义（P>0.05）。治疗12和24周后，2组患者晨僵时间、指地距、枕墙距、Schöber试验、BASDAI评分、BASFI评分、ESR和CRP水平等较治疗前均有明显改善（P<0.05）。治疗期间，依那西普组1例患者出现皮肤红斑，英夫利昔单抗组出现2例中度感染、2例消化系统反应和1例皮肤瘙痒，2组患者不良反应发生率比较差异有统计学意义（P<0.05）。结论：依那西普和英夫利昔单抗对青少年AS均有较好的治疗作用，可有效改善其受累髋关节的症状，2组患者短期疗效相近，但依那西普不良反应发生率略低于英夫利昔单抗。

Clinical efficacy and safety evaluation of etanercept and infliximab in treatment of adolescent ankylosing spondylitis

Objective:To compare the clinical efficacy and safety between etanercept and infliximab in the treatment of adolescent ankylosing spondylitis (AS),and to provide reference for guiding clinical medication.Methods:Sixty male adolescents with AS from our Hospital were used as the subjects and randomly divided into etanercept group and infliximab group (n =30).All patients in the 24 weeks before treatment and during the treatment were not taken the disease-modifying anti-rheumatic drugs (DMARDS).The pillow-wall distance,finger-ground distance,Sch(o)ber test,AS activity index (BASDIA),AS functional Index (BASFI),C-reactive protein (CRP) levels,erythrocyte sedimentation rate (ESR),MRI performance and other indicators of the patients in two groups were measured and evaluated 12 and 24 weeks after treatment,and statistical analysis was performed to assess the clinical efficacies of the two drugs and the adverse effects were recorded.Results:Etanercept and infliximab had good effects on the AS 24 weeks after treatment,and the pain of low back and lumbosacral of thepatients in two groups were significantly reduced or disappeared,and the total clinical efficacies in two groups were 96％ and 93％,respectively (P＞0.05).There were significant improvements in the indexes of morning stiffness,finger-ground distance,pillow-wall distance,Sch(o)ber test,BASDAI scores,BASFI scores,ESR and CRP levels of the patients in two groups 12 and 24 weeks after treatment compared with before treatment (P＜0.05).During treatment,1 case of erythema was found in etanercept group;2 cases of moderate infection,2 cases of digestive system reaction,and 1 case of pruritus were found in infliximab group;the differences in the incidence rates of adverse effects between two groups were statistically significant (P＜0.05).Conclusion:Etanercept and infliximab have good therapeutic effects in the adolescent patients with AS.They can improve the joint symptoms of hip joint involved in AS;the short-term efficacies of the patients in two groups have no significant difference,but the incidence rate of adverse effects of etanercept is slightly less than that of infliximab.