99Tc-亚甲基二膦酸盐联合来氟米特治疗类风湿关节炎疗效观察

目的 观察锝-亚甲基二膦酸盐注射液(99Tc-2MDP,商品名:云克)联合来氟米特治疗类风湿关节炎(rheumatoid arthritis,RA)的临床疗效.方法 将68例RA患者随机分为观察组和对照组各34例,观察组采用99Tc-2M DP静脉滴注,同时口服来氟米特治疗,对照组仅口服来氟米特治疗.比较两组患者4周后晨僵时间、关节肿胀数、关节压痛数、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)滴度,同时观察不良反应.结果 两组患者各项疗效指标治疗后均有改善,总有效率比较,差异有统计学意义(P＜0.05).经4周治疗后观察组晨僵时间、关节压痛数、关节肿胀数、ESR、CRP、RF滴度各项指标较治疗前明显改善,治疗后两组晨僵时间、关节压痛数、关节肿胀数、ESR比较,差异有统计学意义(P＜0.05),两组均无严重不良反应.结论 云克联合来氟米特治疗RA安全、高效,能有效降低病情活动性,值得临床推广.

Effective observation of 99Tc-2MDP combined with leflunomide for treating rheumatoid arthritis

Objective To observe the clinical efficacy of 99Tc-2MDP injection combined with leflunomide(LEF) on treating rheumatoid arthritis(RA).Methods 68 patients with RA were randomly divided into two groups,34 cases in each group.The control group(n=34) was given 99Tc-2MDP by intravenous drip combined with oral LEF,and the control group(n=34) was given oral LEF only.After 4-week treatment,the time of morning stiffness,number of swelled joints,number of joint tenderness,erythrocyte sedimentation rate(ESR),C reactive protein(CRP) and rheumatoid factor(RF) were compared between the two groups.At the same time,the adverse reactions were observed.Results The various effective indexes were improved after treatment in the two groups.Comparing the two groups,the total effective rates had statistical difference(P<0.05).After 4-week treatment,the time of morning stiffness,number of swelled joints,number of joint tenderness,ESR,CRP and RF in the observation group were significantly improved,which had statistical diference compared with the contol group(P<0.05).Conclusion 99Tc-2MDP combined with LEF can efficiently reduce the activity of RA with safety and high efficiency,which can deserve to be clinically popularized.