摘要
Abstract
Objective:To explore the effect of Tocilizumab combined with Methotrexate in the treatment of patients with rheumatoid arthritis(RA)and its influence on level of helper T cells.Method:Seventy-two patients with RA who admitted to Zhangzhou Affiliated Hospital of Fujian Medical University from January 2021 to August 2023 were selected as the study objects,they were divided into the control group(Methotrexate)and the observation group(Tocilizumab on the basis of control group)according to the random number table method according to the random number table method,36 cases in each group.The clinical efficacy,morning stiffness time,number of joint swelling and tenderness,erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),interleukin-8(IL-8),C-reactive protein(CRP),immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),T regulatory cell(Treg),T helper cell-1(Th1)and adverse reactions were compared between two groups.Result:The response rate of American College of Rheumatology 20%improvement criteria(ACR20)in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the morning stiffness times in two groups were shorter than those before treatment,the numbers of joint swelling and tenderness were lower than those before treatment,and the morning stiffness time in the observation group was shorter than that in the control group,the numbers of joint swelling and tenderness were less than those in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of serum ESR,IL-6,IL-8,CRP,IgG and Th1 in two groups were lower than those before treatment,and the levels of each indexes in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).However,there were no significant differences in the levels of serum IgA and IgM between two groups after treatment(P>0.05).After treatment,the levels of Treg in two groups were higher than those before treatment,and the level of Treg in the observation group was higher than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:The effect of Tocilizumab combined with Methotrexate in the treatment of patients with RA is ideal,which can alleviate clinical symptoms,reduce inflammatory response,regulate immunoglobulin and helper T cell levels,and has high safety.关键词
托珠单抗/甲氨蝶呤/类风湿关节炎/T辅助细胞-1/调节性T细胞Key words
Tocilizumab/Methotrexate/Rheumatoid arthritis/T helper cell-1/T regulatory cell
