来源：风湿病与关节炎,2017,6（8）:34-37.

艾拉莫德治疗中重度类风湿关节炎的疗效评价及对骨代谢的影响（临床研究）

马　超，李仿模，陈炜炜

　　【摘　要】目的：探讨艾拉莫德治疗中重度类风湿关节炎患者骨代谢指标的变化。方法：将64例中重度类风湿关节炎患者随机分为治疗组和对照组，每组32例。对照组给予常规药物治疗，治疗组给予艾拉莫德治疗。2组1个疗程均为24周。比较2组患者骨代谢指标和疾病活动度指标变化。结果：治疗后，2组血清25羟维生素D3指标比较，差异无统计学意义（t = 1.7121，P = 0.0919）。治疗组N-端骨钙素、总Ⅰ型前胶原氨基端延长肽、Ⅰ型胶原降解产物指标明显优于对照组，2组比较，差异有统计学意义（P < 0.05）。2组红细胞沉降率（ESR）、C-反应蛋白、压痛关节数、肿胀关节数指标较治疗前均降低（P < 0.05），且治疗组优于对照组（P < 0.05）。治疗组不良反应发生率34.38%，低于对照组的46.88%。结论：艾拉莫德治疗中重度类风湿关节炎患者24周后骨代谢指标明显改善，疾病活动度减低，不良发应发生减少。

　　【关键词】　关节炎，类风湿；艾拉莫德；骨代谢指标

Efficacy of Iguratimod in the Treatment of Moderate to Severe Rheumatoid Arthritis and Its Effect on Bone Metabolism

MA Chao,LI Fang-mo,CHEN Wei-wei

　　【ABSTRACT】Objective:To investigate the changes of bone metabolism in patients with moderate to severe rheumatoid arthritis treated with Iguratimod.Methods:Sixty-four patients with moderate to severe rheumatoid arthritis were randomly divided into a treatment group and a control group,32 cases in each group.The control group was given conventional medicine,and the treatment group was treated with Iguratimod.The two groups were treated for 24 weeks as a course.The changes of bone metabolism index and disease activity index of the two groups were compared.Results:After treatment,there was no significant difference in serum 25 hydroxy vitamin D3 index between the two groups（t = 1.7121,P = 0.0919）.The N-MID,Total-PINP and Crosslaps index in the treatment group were significantly better than those in the control group,and the difference between the two groups was statistically significant（P < 0.05）.The ESR,C-reactive protein,TJC and swelling joint index of the two groups were lower than before treatment（P < 0.05）,and the treatment group was better than the control group（P < 0.05）.The incidence of adverse reactions in the treatment group was 34.38%,which was lower than that of the control group（46.88%）.Conclusion:After 24-week treatment with Iguratimod,the bone metabolism index of patients with moderate to severe rheumatoid arthritis has significantly improved,and disease activity and adverse reaction have decreased.

　　【Keywords】arthritis,rheumatoid;Iguratimod;bone metabolism index