托珠单抗对类风湿关节炎患者疗效、免疫球蛋白及辅助性T细胞水平的影响

目的 观察托珠单抗对类风湿关节炎（RA）患者的疗效，以及对患者免疫球蛋白、辅助性T细胞水平的影响。方法 选择本院收治的RA患者90例，随机分为对照组与观察组，每组45例。对照组患者接受英夫利西单抗联合甲氨蝶呤治疗方案，观察组患者接受托珠单抗联合甲氨蝶呤治疗方案。两组患者均连续治疗6个月。比较两组患者治疗后的临床疗效；分别检测两组患者治疗前后血清中免疫球蛋白、T辅助细胞-1（T helper1，Th1）以及调节性T细胞（T Regulatory，Treg）的水平。结果 治疗后，两组患者晨僵、关节压痛及关节肿胀情况均有所好转，且观察组患者的上述症状情况好转程度明显优于对照组（P<0.05）。两组患者血清中IgG及Th1细胞水平均显著降低，且观察组患者血清中2种细胞水平显著低于对照组（P<0.05）；而两组患者Treg细胞水平均有明显升高，且观察组Treg水平显著高于对照组（P<0.05）。结论 托珠单抗可有效改善RA患者临床症状，改善患者免疫功能紊乱，具有较好的临床疗效。

Effects of tocilizumab on the efficacy, immunoglobulin and helper T cells in patients with rheumatoid arthritis

Objective To observe the effects of tocilizumab on the efficacy, immunoglobulin and helper T cells in patients with rheumatoid arthritis.Methods 90 patients with rheumatoid arthritis in our hospital were randomly divided into control group and observation group, 45 cases in each group. The patients in the control group were treated with infliximab and methotrexate. The patients in the observation group were treated with tocilizumab and methotrexate. The patients in the two groups were both treated for 6 months. The clinical efficacy of the two groups was compared after treatment. Before and after treatment, the serum levels of immunoglobulin, Th-1 and Treg of patients in two groups were measured.Results The results showed that after treatment, the situation of morning stiffness, joint pressure pain and joint swelling of the patients in the two groups were improved, and the improvement of morning stiffness, joint pressure pain and joint swelling in the observation group was greater (P<0.05). The levels of IgG and Th1 cells in the serum of patients in the two groups significantly decreased, and the levels of IgG and Th1 cells in the serum of the patients in the observation group were significantly lower than that of the control group (P<0.05). The serum level of Treg cells in the serum of patients in the two groups increased significantly, and the level of Treg in the serum of patients in the observation group was significantly higher than that in the control group (P<0.05).Conclusion Topazumab could effectively improve the clinical symptoms of patients with rheumatoid arthritis, and improve the immune dysfunction of the patients with better clinical efficacy.