疾病活动性指标对评估英夫利昔单抗治疗类风湿关节炎早期疗效的作用

Role of disease activity indexes in assessment of early efficacy of rheumatoid arthritis patients with infliximab treatment

  • 摘要: 目的:探讨疾病活动性指标对评估英夫利昔单抗(IFX)治疗中重度活动性类风湿关节炎(RA)患者早期疗效的作用。方法14例中重度活动性 RA 患者初次接受 IFX 200 mg 滴注,分别于0 h(基线),滴注后3 h、6 h、24 h、3 d、7 d 和14 d进行疾病活动性指标评估。主要指标:肿胀关节数目(SJC)、触痛关节数目(TJC)、血清 C-反应蛋白(CRP)、血沉(ESR)、疾病活动指数(DAS)28-CRP、健康评估问卷(HAQ)和类风湿因子(RF)。结果SJC、TJC、CRP、ESR、DAS28-CRP、HAQ 及 RF 等指标均在治疗第14天时明显改善,其中 TJC 在治疗3 d 后开始减少,SJC 和 HAQ 在治疗7 d 后改善,CRP 和 DAS28-CRP 于滴注后6 h 即开始下降。CRP 在3 d 时达到低谷,7 d 后逐渐回升,14 d 时仍低于基线水平。结论CRP 和 DAS28-CRP 是反映 IFX治疗 RA 早期疗效的最敏感指标,可作为 IFX 早期疗效的预测因素。

     

    Abstract: Objective To explore the role of disease activity indexes (DAS)in assessment of early efficacy of rheumatoid arthritis (RA)patients with infliximab (IFX)treatment.Methods 14 patients with moderate and severe activity RA were firstly treated with an intravenous infusion of 200 mg IFX.The levels of the swollen joint count (SJC),tender joint count (TJC),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),DAS28-CRP,the health assessment questionnaire (HAQ)and rheumatoid factor (RF)were evaluated at 0 hour (baseline),3,6,24 hours after infu-sion and 3,7 and 14 days after IFX infusion.Results SJC,TJC,CRP,ESR,DAS28-CRP,HAQ and RF improved significantly on 14th day,in which TJC reduced 3 days after treatment,SJC and HAQ improved 7 days after treatment,CRP and DAS28-CRP started to decrease 6 hours immediately after IFX infusion.CRP level was the lowest on third day,and then gradually recovered 7 days after treatment,and remained below the baseline level on 14th day.Conclusion As the most sensitive in-dexes reflecting the early efficacy of IFX for RA,both CRP and DAS28-CRP can be used as the pre-dictive factors for IFX early efficacy.

     

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