艾拉莫德对类风湿关节炎患者免疫功能及血清RF 抗-CCP及Wnt-3α的影响

doi:10.3969/j.issn.1006-6233.2021.05.07

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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.

Key words： Rheumatoid arthritis Iguratimod Methotrexate Secreted glycoprotein (Wnt)-3α

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.05.07 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I5/732

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