益赛普对携带HL1-B27基因的未分化脊柱关节病患者的疗效

目的评价肿瘤坏死因子抑制剂益赛普治疗携带HLA—B27基因的未分化脊柱关节病（uSPA）患者的临床疗效和安全性。方法将56例HLA—B27阳性uSpA患者分成两组，试验组36例应用生物制剂益赛普25mg／次，每周2次皮下注射，联合传统治疗方案慢作用改善病情药物＋非甾类抗炎药（甲氨蝶呤10mg/周＋美洛昔康7．5mg／d）治疗；对照组20例使用传统治疗方案，同等剂量甲氨蝶呤＋美洛昔康治疗，疗程12周，记录各组治疗前后患者的症状、体征、疾病功能指数（BASFAI）、红细胞沉降率（ESR）及C-反应蛋白（CRP）等实验室指标及不良反应。结果试验组使用益赛普治疗1周，12周后患者的脊柱痛与夜间痛程度均明显改善，BASFAI、血沉、CRP均显著下降，与对照组比较差异有统计学意义（P〈0．05）。试验组治疗12周后达到疗效20％、50％、70％改善的患者分别为34例（94．4％）、32例（88．9％）、29例（80．6％），均优于对照组（P〈0．05）。不良反应主要为注射部位反应。结论益赛普治疗HLA—B27阳性uSpA患者临床效果显著，安全性和耐受性好。

Effect of Etanercept on undifferentiated spondyloarthropathies patients carrying HLA-B27 gene

Objective To evaluate the efficacy and safety of Etanereept in the treatment of undifferentiated spondyloarthropathies （uSpA） patients with positive HLA-B27. Methods The 56 uSpA patients carrying HLA-B27 were devided into experimental group（36 cases） and treated with combinated treatment of Etanercept and conventional medication （MTX10mg/w＋Meloxicam 7.5mg/d）and the control group （20 cases） treated with conventional medication. Activity and efficacy evaluation indexes were compared between the two groups after treatment for a course of 12 weeks.The therapeutic effect in both groups after treatment were observed and compared. Results The symptom, signs, functional index,erythroeyte sedimentation rate, level of C-reactive protein in case of experimental group were significantly improved a week and 12 weeks after treatment compared to those in the control group （P〈0.05）. Conclusion The efficacy of Etanercept was significant in treatment of uSpA patients carrying HLA-B27 with high safety and good tolerance.