目的 探討阿達(dá)木單抗聯(lián)合甲氨蝶呤和硫酸羥氯喹治療類風(fēng)濕關(guān)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(xué)附屬宿州醫(yī)院收治的100例類風(fēng)濕關(guān)節(jié)炎患者。依據(jù)用藥情況分為對(duì)照組（50例）和治療組（50例）。對(duì)照組患者口服甲氨蝶呤片10 mg/次，1次/周，同時(shí)口服硫酸羥氯喹片0.2 g/次，2次/d。治療組在對(duì)照組基礎(chǔ)上皮下注射阿達(dá)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(fēng)濕簡(jiǎn)化疾病活動(dòng)指數(shù)（SDAI）評(píng)分和生活質(zhì)量量表（QLQ-C30）評(píng)分，免疫因子指標(biāo)免疫球蛋白G（IgG）、免疫球蛋白M（IgM）和類風(fēng)濕因子（RF）及炎性因子指標(biāo)白細(xì)胞介素-17（IL-17）、腫瘤壞死因子-α（TNF-α）和IL-6水平。結(jié)果 治療后，治療組臨床總有效率為94.00%，明顯高于對(duì)照組的78.00%（P＜0.05）。治療后，兩組患者SDAI評(píng)分降低明顯，QLQ-C30評(píng)分均高于治療前（P＜0.05），且治療組SDAI評(píng)分和QLQ-C30評(píng)分明顯好于對(duì)照組（P＜0.05）。治療后，兩組患者IgG、IgM、RF、IL-17、TNF-α和IL-6指標(biāo)水平均低于治療前（P＜0.05），且治療組指標(biāo)水平均明顯低于對(duì)照組（P＜0.05）。結(jié)論 阿達(dá)木單抗聯(lián)合甲氨蝶呤和硫酸羥氯喹治療類風(fēng)濕關(guān)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(zhì)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(diǎn)研究與開發(fā)計(jì)劃項(xiàng)目(202104j07020054)