TNF-α拮抗剂对激素联合环磷酰胺治疗类风湿关节炎合并间质性肺病疗效的影响

doi:10.3969/j.issn.1006-6233.2021.05.05

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Abstract Objective: To explore new treatment options for rheumatoid arthritis with interstitial lung disease (RA-ILD) in consideration of the poor efficacy of immunosuppressive therapy. Methods: Comparing the erythrocyte sedimentation rate (ESR) of 58 patients with rheumatoid arthritis without interstitial lung disease (RA-NILD) and 30 patients with RA-ILD, as well as levels of C-reactive protein (CRP), C3, C4, rheumatoid factor (RF), CCP antibody (CCP-Ab), TNF-α, IFN-γ, TGF-β, IL-12, IL-2, IL-4, IL-13, IL-17, MCP-1 and KL-6 in serum, and the relationship between various indicators and the incidence of RA-ILD were explored. With TNF-α antagonist combined with prednisone and cyclophosphamide or prednisone combined with cyclophosphamide for the treatment of RA-ILD, these cytokines were tested again to explore the effectiveness of golimumab for the treatment of RA-ILD. Results: The results showed that serum levels of TGF-β, TNF-α, CCP-Ab, IL-2, IL-17, KL-6 and MCP-1 were significantly higher in patients with RA-ILD than those in patients with RA-NILD. In addition, the negative conversion rate of these indicators in serum of patients treated with TNF-α antagonist combined with prednisone and cyclophosphamide was significantly higher than that of patients treated with prednisone combined with cyclophosphamide. Conclusion: TNF-α antagonist optimizes the therapeutic effect of prednisone combined with cyclophosphamide, and provides a new direction for the treatment of RA-ILD patients.

Key words： TNF-α antagonist Interstitial lung disease Rheumatoid arthritis Prednisone

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.05.05 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I5/723

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