来源：风湿病与关节炎,2022,11（4）:16-20.

血清淀粉样蛋白A和C反应蛋白在类风湿关节炎治疗后的变化（临床研究）

王玉伟¹，金　迪¹，朱艳飞¹，王小磊²

　　【摘　要】目的：比较抗肿瘤坏死因子-α（TNF-α）治疗药物注射用重组人Ⅱ型肿瘤坏死因子受体抗体融合蛋白（益赛普）和改善病情抗风湿药物（DMARDs）对类风湿关节炎（RA）患者血清淀粉样蛋白A（SAA）、C反应蛋白（CRP）水平的影响，探讨SAA、CRP在RA药物治疗后的临床应用价值。方法：选取2018年8月至2020年3月来院就诊的RA患者126例，接受甲氨蝶呤（MTX）、三联DMARDs［MTX + 羟氯喹（HCQ）+柳氮磺吡啶（SSZ）］以及MTX+益赛普治疗的患者各57，41，28例，收集一般资料并检测治疗前、治疗后12周血清SAA和CRP水平。结果：MTX组、三联DMARDs组、MTX +益赛普3组治疗后血清SAA、CRP水平均显著降低（P < 0.05）；MTX组、三联DMARDs组、MTX +益赛普3组治疗后SAA、CRP与DAS28-ESR评分均呈正相关（r ＝ 0.653，0.657，均P < 0.05；r ＝ 0.650，0.689，均P < 0.05；r ＝ 0.720，0.586，均P < 0.05）。结论：RA患者经DMARDs及抗TNF-α治疗后血清SAA、CRP水平降低，血清SAA、CRP水平与治疗后疾病活动度均呈正相关。

　　【关键词】　类风湿关节炎；血清淀粉样蛋白A；C反应蛋白；抗肿瘤坏死因子-α治疗；改善病情抗风湿药；疾病活动度；相关性

Changes of Serum Amyloid A and C-reactive Protein after the Treatment of Rheumatoid Arthritis

WANG Yu-wei,JIN Di,ZHU Yan-fei,WANG Xiao-lei

　　【ABSTRACT】Objective:To compare the effects of Etanercept and DMARDs on the levels of SAA and CRP in patients with rheumatoid arthritis（RA）,and to explore the clinical application value of SAA and CRP after treatment.Methods:One hundred and twenty-six RA patients came to the hospital from August 2018 to March 2020 were selected,among them 57,41 and 28 patients were respectively treated with MTX,triple DMARDs（MTX + HCQ + SSZ）and MTX + etanercept.The general data were collected and the levels of SAA and CRP were measured before and 12 weeks after treatment.Results:The levels of SAA and CRP in the MTX group,the triple DMARDs group and the MTX + etanercept group decreased significantly after treatment（P < 0.05）;After treatment,SAA and CRP were positively correlated with DAS28-ESR in the MTX group,the triple DMARDs group and the MTX + etanercept group（r = 0.653,0.657,P < 0.05;r = 0.650,0.689,P < 0.05;r = 0.720,0.586,P < 0.05）.Conclusion:After treatment of RA with DMARDs and Etanercept,the levels of SAA and CRP decreased,and the levels of serum SAA and CRP were positively correlated with the disease activity after treatment.

　　【Keywords】rheumatoid arthritis;serum amyloid A;C-reactive protein;anti-tumor necrosis factor-α treatment;DMARDs;disease activity;relevance