|
|
Effects of Iguratimod on Immune Function and Serum RF Anti-CCP and Wnt-3α in Patients with Rheumatoid Arthritis |
LIU Ying, LIN Shudian, PAN Chuying, et al |
Hainan General Hospital / Hainan Affiliated Hospital of Hainan Medical University, Hainan Haikou 570000, China |
|
|
Abstract Objective: To observe the application effects of iguratimod on rheumatoid arthritis (RA) and its effects on immune function, serum indexes and functional status of patients. Methods: A total of 156 patients with active RA admitted from January 2019 to June 2020 were selected and divided into observation group and control group according to the odd and even numbers of hospitalization order, with 78 cases in each group. Control group was given oral methotrexate (once for 10mg, once/week), and observation group was given oral iguratimod (once for 25 mg, twice/day) on the basis of control group, and they were continuously treated for 12 weeks. The 28 joint disease activity score (DAS28) and treatment response were compared between the two groups, and the levels of immune function indicators (helper T cells Th1 and Th17 and regulatory T cells) and serum indicators [C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (anti-CCP), secreted glycoprotein (Wnt)-3α] were analyzed before and after treatment, and Health Assessment Questionnaire (HAQ) was used to evaluate the functional status of patients, and adverse drug reactions were recorded. Results: 12 weeks after treatment, the DAS28 value of the two groups was significantly lower than that before treatment (P<0.05), and the decrease in observation group was greater than that in control group (P<0.05). The total response rate in observation group was significantly higher than that in control group (97.44% vs 88.46%) (P<0.05). The percentages of Th1 and Th17 in the two groups were significantly lower than those before treatment (P<0.05) while the percentage of regulatory T cells was significantly higher than that before treatment (P<0.05), and the decreases of percentages of Th1 and Th17 in observation group were greater than those in control group (P<0.05), and the increase of percentage of regulatory T cells was greater than that in control group (P<0.05). The levels of serum CRP, RF and anti-CCP and expression level of Wnt-3α in the two groups were significantly lower than those before treatment (P<0.05), and the decreases of levels of serum CRP, RF and anti-CCP and expression level of Wnt-3α in observation group were greater than those in control group (P<0.05). The HAQ score of the two groups was significantly lower than that before treatment (P<0.05), and the decrease of HAQ score in observation group was greater than that in control group (P<0.05). There was no significant difference in the incidence rate of adverse reactions between observation group and control group (10.26% vs 6.41%) (P>0.05). Conclusion: Iguratimod in the treatment of RA can improve the response rate of treatment, help regulate the immune function, relieve the inflammation level, and promote the recovery of functional status, with good safety.
|
|
|
|
|
[1] 杨群智,张舸,和晶.类风湿关节炎患者肿瘤坏死因子-α-308(G/A)基因多态性与依那西普疗效相关性分析[J].河北医学,2018,24(5):774~777. [2] 莫美丽,唐东兴,张筠,等.甲氨蝶呤联合艾拉莫德治疗活动性类风湿关节炎的随机对照试验[J].福建医科大学学报,2018,52(4):245~248. [3] 曹丽娜,殷寒秋,李朝虹,等.艾拉莫德治疗老年类风湿关节炎的临床效果及对骨代谢的影响[J].中国老年学,2018,38(22):5500~5502. [4] 中华医学会风湿病学分会.2018中国类风湿关节炎诊疗指南[J].中华内科杂志,2018,57(4):242~251. [5] 郭伟.艾拉莫德治疗早期类风湿关节炎6个月的疗效和安全性研究[D].山东大学,2019. [6] 王璐,梁慧敏,魏蔚,等.基于自我效能理论的功能锻炼指导在类风湿关节炎患者中的应用研究[J].中国实用护理杂志,2019,35(10):744~749. [7] 许珂,蔡永松,鲁超,等.甲氨蝶呤通过诱导自噬促进类风湿关节炎滑膜成纤维细胞凋亡机制的研究[J].中华风湿病学杂志,2019,23(2):106~109. [8] Jin S,Li M,Fang Y,et al.Chinese registry of rheumatoid arthritis (CREDIT): Ⅱ.prevalence and risk factors of major comorbidities in Chinese patients with rheumatoid arthritis[J].Arthritis Res Ther,2017,19(1):251. [9] 穆培霞,马玲,付冬冬,等.艾拉莫德对类风湿关节炎滑膜细胞凋亡及炎症因子水平的影响[J].郑州大学学报(医学版),2020,55(3):364~368. [10] 李炳彤.艾拉莫德对类风湿关节炎患者外周血白细胞瓜氨酸化的影响及机制研究[D].吉林大学,2020. [11] 李学荣,陈永平,张榜硕,等.艾拉莫德联合依那西普对难治性类风湿关节炎患者CD4+,CD8+T细胞及免疫球蛋白的影响[J].免疫学杂志,2018,2(34):55~59. [12] 黄颖,姚血明,唐芳,等.艾拉莫德对胶原诱导性关节炎大鼠模型的抗炎作用[J].风湿病与关节炎,2017,3(38):7~9,27. [13] 冯佳,龚书识,夏燕,等.艾拉莫德对类风湿关节炎外周血破骨细胞分化及破骨细胞相关基因表达的影响[J].中国骨质疏松杂志,2019,25(1):97~102. [14] 王清泰,肖燕萍,章尤权,等.艾拉莫德对类风湿关节炎患者Th17细胞与Treg细胞失衡的调节作用[J].医疗装备,2018,31(10):6~8. [15] 李昊隆,李永哲.类风湿性关节炎生物标志物的研究新进展[J].中华检验医学杂志,2019,42(9):723~730. |
|
|
|