来氟米特联合泼尼松治疗多发性肌炎的临床观察
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篇名: 来氟米特联合泼尼松治疗多发性肌炎的临床观察
TITLE:
摘要: 目的:观察来氟米特联合泼尼松治疗多发性肌炎的疗效和安全性。方法:选取我院收治的98例多发性肌炎患者,按随机数字表法分为观察组和对照组,每组49例。对照组患者给予泼尼松片口服,初始给药剂量为60~100 mg/d,每日3次,然后根据患者肌酸肌酶(CK)及临床症状的改善情况逐渐减量至维持剂量10 mg/d,每日3次。观察组患者在对照组治疗基础上加服来氟米特片10 mg,每日2次。两组疗程均为120 d。观察两组患者临床疗效和肌力评价情况,比较治疗前后肌酶谱[包括CK、乳酸脱氢酶(LDH)、天冬氨酸转氨酶(AST)、肌酸磷酸激酶(CPK)、丙氨酸转氨酶(ALT)]、血清炎症因子水平[包括白细胞介素2(IL-2)、IL-8、IL-12、肿瘤坏死因子α(TNF-α)和超敏C反应蛋白(hs-CRP)]水平,同时记录不良反应发生情况。结果:治疗后观察组患者临床总有效率(87.8%)和肌力达3级率(81.6%)均显著高于对照组(分别为75.5%、55.1%),总不良反应发生率显著低于对照组(12.2% vs. 22.4%),差异均有统计学意义(P<0.05)。治疗后,两组患者肌酶谱和血清炎症因子水平均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。结论:来氟米特联合泼尼松治疗多发性肌炎疗效较好,可以显著提升患者肌力,改善肌酶谱和血清炎症因子水平,且安全性较好。
ABSTRACT: OBJECTIVE: To observe the clinical efficacy and safety of leflunomide combined with prednisone in the treatment of polymyositis. METHODS: Totally 98 polymyositis patients in our hospital were divided into observation group and control group by random number table, 49 cases in each group. Control group received Prednisone tablet with initial dose of 60-100 mg/d, tid, then gradually reduced to maintaining dose of 10 mg/d, tid, based on patients’ improvement of creatine kinase (CK) and clinical symptoms. Observation group was additionally given Leflunomide tablet 10 mg, bid, based on the control group. They all treated for 120 d. Clinical efficacy, muscle strength evaluation, muscle enzymes [including CK, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), creatine phosphokinase (CPK), alanine aminotransferase (ALT)] and serum inflammatory factors (including IL-2, IL-8, IL-12, TNF-α, hs-CRP) before and after treatment in 2 groups were observed, the incidence of adverse reactions in 2 groups was recorded. RESULTS: After treatment, the total effective rate (87.8% vs. 75.5%) and muscle strength achieving grade 3 (81.6% vs. 55.1%) in observation group were significantly higher than control group, and the total adverse reaction rate (12.2% vs. 22.4%) was lower than control, with statistically significances (P<0.05). After treatment, the muscle enzymes and serum inflammatory factor levels in groups were significantly lower than before, and observation group was lower than control group, with statistically significances (P<0.05). CONCLUSIONS: Leflunomide combined with prednisone shows good efficacy in the treatment of polymyositis, it can significantly improve the muscle strength, muscle enzymes and serum inflammatory factor levels, and dose not increase the incidence of adverse reactions, with good safety.
期刊: 2017年第28卷第15期
作者: 龚红英,徐光辉
AUTHORS: GONG Hongying,XU Guanghui
关键字: 来氟米特;泼尼松;多发性肌炎;疗效;安全性
KEYWORDS: Leflunomide; Prednisone; Polymyositis; Therapeutic efficacy; Safety
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