糖皮质激素联合慢作用抗风湿药治疗类风湿关节炎的临床观察

目的观察小剂量糖皮质激素联合慢作用抗风湿药物治疗类风湿关节炎的临床疗效。方法将76例初发类风湿关节炎患者随机分为小剂量糖皮质激素联合慢作用抗风湿药物组(激素联合治疗组,共38例)及慢作用抗风湿药物治疗组(对照组,共38例),两组均给予慢作用抗风湿药物,其中激素联合治疗组另给予小剂量糖皮质激素,对照组给予洛索洛芬钠治疗,全部患者在治疗前与治疗后2、4、12、24周检测临床指标、免疫学指标及足跟骨密度值。结果治疗后联合治疗组VAS评分、DAS28评分及ESR、CRP水平与治疗前、同期对照组相比,差异均有统计学意义(P<0.05)。治疗24周,两组足跟骨密度值比较差异无统计学意义(P>0.05)。结论小剂量糖皮质激素联合慢作用抗风湿药物可在短期内明显缓解临床症状,降低炎性指标,且短期内未见增加骨质疏松风险。

Clinical observation of glucocorticoid and DMARDs treatment for rheumatoid ar thritis

Objective To explore the efficacy of low-dose glucocorticoid and modifying anti-rheumatic drugs in the treatment of rheumatoid arthritis( RA) . Methods Totally 76 cases of RA patients were divided into two groups:low-dose glucocorticoid and DMARDS group (combination therapy group,n=38),DMARs group (control group,n=38). Both groups were given the same DMARDs,and the combination therapy group was also given low-dose glucocor-ticoid. All the clinical and immunological variables were measured at baseline and 2,4,12 and 24 weeks after treat-ment. Bone mineral density ( BMD) was measured at baseline and 24 weeks after treatment. Results Compared with prior treatment and control group,there was significant difference in VAS scores,DAS 28 scores and the levels of ESR and CRP in combination therapy group ( P <0. 05 ) . There was no significant difference in bone mineral density be-tween the two groups (P>0. 05). Conclusion The treatment of low-dose glucocorticoid and DMARDs is effective in improving the clinical symptoms and immunological variables without the risks of osteoporosis in short time.