目的 探討阿達木單抗聯(lián)合甲氨蝶呤和硫酸羥氯喹治療類風濕關節(jié)炎的臨床療效。方法 選取2022年1月—2024年2月安徽醫(yī)科大學附屬宿州醫(yī)院收治的100例類風濕關節(jié)炎患者。依據用藥情況分為對照組（50例）和治療組（50例）。對照組患者口服甲氨蝶呤片10 mg/次，1次/周，同時口服硫酸羥氯喹片0.2 g/次，2次/d。治療組在對照組基礎上皮下注射阿達木單抗注射液，40 mg/次，1次/2周。兩組患者連續(xù)用藥12周。觀察兩組患者臨床療效，比較治療前后兩組患者類風濕簡化疾病活動指數（SDAI）評分和生活質量量表（QLQ-C30）評分，免疫因子指標免疫球蛋白G（IgG）、免疫球蛋白M（IgM）和類風濕因子（RF）及炎性因子指標白細胞介素-17（IL-17）、腫瘤壞死因子-α（TNF-α）和IL-6水平。結果 治療后，治療組臨床總有效率為94.00%，明顯高于對照組的78.00%（P＜0.05）。治療后，兩組患者SDAI評分降低明顯，QLQ-C30評分均高于治療前（P＜0.05），且治療組SDAI評分和QLQ-C30評分明顯好于對照組（P＜0.05）。治療后，兩組患者IgG、IgM、RF、IL-17、TNF-α和IL-6指標水平均低于治療前（P＜0.05），且治療組指標水平均明顯低于對照組（P＜0.05）。結論 阿達木單抗聯(lián)合甲氨蝶呤和硫酸羥氯喹治療類風濕關節(jié)炎，能夠有效改善患者的病情，減輕其疼痛癥狀，并能有效降低炎癥因子，患者的生活質量有所改善。

Objective To explore the clinical effect of adalimumab combined with methotrexate and hydroxychloroquine sulfateand in treatment of rheumatoid arthritis. Methods Patients (100 cases) with rheumatoid arthritis in Suzhou Hospital of Anhui Medical University from January 2022 to February 2024 were divided into control (50 cases) and treatment (50 cases) group based on different treatments. Patients in the control group were po administered with Methotrexate Tablets, 10 mg/time, once weekly, and they were po administered with Hydroxychloroquine Sulfate Tablets, 0.2 g/time, twice daily. Patients in the treatment group were subcutaneous injection administered with Adalimumab Injection on the basis of the control group, 40 mg/time, once every two weeks. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, the scores of SDAI and QLQ-C30, the levels of IgG, IgM, RF, IL-17, TNF-α and IL-6 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was 94.00%, which was significantly higher than that in the control group (78.00%, P < 0.05). After treatment, the SDAI scores of patients in both groups were significantly decreased, the QLQ-C30 scores were higher than before treatment (P < 0.05), and the SDAI scores and QLQ-C30 scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of IgG, IgM, RF, IL-17, TNF-α and IL-6 in two groups were lower than those before treatment (P < 0.05), and the levels of indicators in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The combination of adalimumab combined with methotrexate and hydroxychloroquine sulfateand can effectively improve the condition of rheumatoid arthritis patients, alleviate their pain symptoms, and effectively reduce inflammatory factors, and the quality of life of patients has been improved.

R982

安徽省重點研究與開發(fā)計劃項目(202104j07020054)