多聚谷氨酸化甲氨蝶呤浓度与类风湿关节炎疗效相关性研究

目的 探讨经甲氨蝶呤(methotrexate,MTX)治疗的类风湿关节炎(rheumatoid arthritis,RA)患者红细胞内多聚谷氨酸化甲氨蝶呤(methotrexate polyglutamate,MTXPG)的浓度与其疾病活动度的关系.方法 选取76例经MTX治疗3个月的RA患者进行横断面研究,采用EL...

Correlation of methotrexate polyglutamate concentration in erythrocyte with methotrexate efficacy in rheumatoid arthritis patients

Objective To investigate the correlation between the disease activity and methotrexate polyglutamate(MTXPG) concentration in the erythrocytes of rheumatoid arthritis(RA) patients treated with methotrexate(MTX).Methods Seventy-six cases of RA patients,treated with MTX for 3 months,were selected for the cross-sectional study.MTXPG concentrations in the erythrocytes of RA patients were measured by ELISA.The seventy-six cases were divided into a remarkably effective group,an effective group and an ineffective group based on disease activity score(DAS28) after treatment as well as DAS28 difference before and after treatment.MTXPG concentrations were compared among the above groups,and their correlation with MTX efficacy on RA was analyzed.Results The numbers of RA patients in the remarkably effective group,effective group and ineffective group were 21,41 and 14,respectively.MTXPG concentrations in the erythrocytes of the remarkably effective group were 158.87±48.27 ng/ml,significantly higher than those of the effective group(105.89±24.23 ng/ml) and ineffective group(85.80±21.30 ng/ml)(P<0.01).MTXPG concentrations were negatively related to CRP(r=-0.628,P=0.000),time of morning stiffness(r=-0.396,P=0.000),swollen joint count(r=-0.321,P=0.005),tender joint count(r=-0.376,P=0.001),visual analogue scale(r=-0.236,P=0.000),and DAS(r=-0.255,P=0.026).However,there was no correlation between MTXPG concentrations and blood sedimentation or health assessment questionnaire(P>0.05).Conclusion MTXPG concentrations in the erythrocytes are significantly different in the remarkably effective group,effective group and ineffective group of RA patients treated with MTX.The higher the MTXPG level,the better the clinical efficacy.