目的 探究注射用重組人Ⅱ型腫瘤壞死因子受體-抗體融合蛋白聯(lián)合甲氨蝶呤治療類風(fēng)濕關(guān)節(jié)炎的效果。方法 選擇2013年1月-2016年12月攀枝花市中心醫(yī)院收治的類風(fēng)濕關(guān)節(jié)炎患者87例為研究對(duì)象，隨機(jī)將其分為42例的對(duì)照組（經(jīng)甲氨蝶呤治療）和45例的觀察組（經(jīng)注射用重組人Ⅱ型腫瘤壞死因子受體-抗體融合蛋白聯(lián)合甲氨蝶呤治療），對(duì)比兩組患者的臨床指標(biāo)、炎性指標(biāo)和血清炎癥因子水平。結(jié)果 治療前，兩組患者的晨僵、關(guān)節(jié)疼痛數(shù)、20 m步行時(shí)間均無差異；治療后，兩組患者的上述指標(biāo)均比治療前顯著降低（P<0.05），且觀察組顯著低于對(duì)照組（P<0.05）。治療前，兩組患者的炎性指標(biāo)類風(fēng)溫因子（RF）、血沉（ESR）及C反應(yīng)蛋白（CRP）均無差異；治療后，兩組患者的上述指標(biāo)均比治療前顯著降低（P<0.05），且觀察組顯著低于對(duì)照組（P<0.05）。治療前，兩組患者的血清炎癥因子水平白介素-6（IL-6）、白介素-10（IL-10）、腫瘤壞死因子-α（TNF-α）均無差異；治療后，兩組患者的IL-6、TNF-α標(biāo)均比治療前顯著降低，IL-10比治療前顯著升高（P<0.05），且觀察組顯著優(yōu)于對(duì)照組（P<0.05）。結(jié)論 注射用重組人Ⅱ型腫瘤壞死因子受體-抗體融合蛋白聯(lián)合甲氨蝶呤可有效改善類風(fēng)濕關(guān)節(jié)炎患者的臨床指標(biāo)、血清炎癥因子水平和炎性指標(biāo)，臨床應(yīng)用價(jià)值較高。

Objective To explore the efficacy of Yisaipu in combination with methotrexate in the treatment of rheumatoid arthritis. Methods We selected 87 patients with rheumatoid arthritis who were admitted to our hospital from January 2013 to December 2016 as research subjects.They were randomly divided into a control group of 42 patients (treated with methotrexate) and a study group of 45 patients (treated with Recombinant Human Tumor Necrosis Factor-αReceptor Ⅱ:IgG Fc Fusion Protein for Injection plus methotrexate). The clinical parameters, inflammatory markers and serum inflammatory factors were compared between the two groups.Results Before treatment, there was no difference in morning stiffness, joint pain, and 20 m walking time between the two groups. After treatment, the above indicators of both groups were lower than before treatment, and the study group was more significant. Before treatment, the RF, ESR, and CRP levels of rheumatoid arthritis were not different between the two groups. After treatment, the above indicators of both groups were lower than before treatment, and the study group was more significant. Before treatment, serum IL-6, IL-10, and TNF-α levels were not different between the two groups. After treatment, both IL-6 and TNNF-α levels were higher than before treatment in both groups. With a decrease, IL-10 was higher than before treatment, and the study group was more significant (P<0.05).Conclusion Recombinant Human Tumor Necrosis Factor-αReceptorⅡ:IgG Fc Fusion Protein for Injection combined with methotrexate can effectively improve clinical indicators, serum inflammatory factors and rheumatoid arthritis related indicators in patients with rheumatoid arthritis, and has higher clinical value.