目的 探讨巴瑞替尼联合柳氮磺吡啶治疗类风湿性关节炎的临床疗效。方法 选取2021年5月-2022年12月海南医学院第一附属医院收治的82例类风湿性关节炎患者，随机法分为对照组（41例）和治疗组（41例）。对照组口服柳氮磺吡啶肠溶片，3粒/次，3次/d。在对照组的基础上，治疗组口服巴瑞替尼片，2 mg/次，1次/d。两组用药90 d。观察两组患者临床疗效，比较治疗前后两组患者症状好转情况，类风湿因子（RF）、红细胞沉降率（ESR）和生活质量评分量表（SF-36）评分，及血清细胞因子高迁移率族蛋白1（HMGB1）、白细胞介素-17（IL-17）、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，治疗组患者总有效率（97.56%）明显高于对照组（82.93%，P<0.05）。治疗后，治疗组临床症状好转情况均显著好于对照组（P<0.05）。治疗后，两组患者RF、ESR指标明显低于治疗前，而SF-36评分指标显著高于治疗前（P<0.05），且治疗组RF、ESR和SF-36评分指标明显好于对照组（P<0.05）。治疗后，两组患者血清细胞因子HMGB1、IL-17、IL-1β、TNF-α水平明显低于治疗前（P<0.05），且治疗组均显著低于对照组（P<0.05）。结论 巴瑞替尼联合柳氮磺吡啶治疗类风湿性关节炎效果确切，能有效降低ESR、RF和炎症因子水平，改善患者生活质量。

Objective To explore the clinical efficiency of baricitinib combined with sulfasalazine in treatment of rheumatoid arthritis. Methods Patients (82 cases) with rheumatoid arthritis in the First Affiliated Hospital of Hainan Medical College from May 2021 to December 2022 were randomly divided into control (41 cases) and treatment (41 cases) group. Patients in the control group were po administered with Sulfasalazine Enteric-coated Tablets, 3 grains/time, three times daily. Patients in the treatment group were po administered with Baricitinib Tablets on the basis of the control group, 2 mg/time, once daily. Patients in two groups were treated for 90 d. After treatment, the clinical evaluation was evaluated, and the improvement of symptom, RF, ESR and SF-36 scores, and the levels of serum HMGB1, IL-17, IL-1β and TNF-α in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of patients in the treatment group (97.56%) was significantly higher than that in the control group (82.93%, P < 0.05). After treatment, the clinical symptom improvement in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the indexes of RF and ESR in two groups were significantly lower than those before treatment, while SF-36 score was higher than that before treatment (P < 0.05), and RF, ESR and SF-36 scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of serum cytokines HMGB1, IL-17, IL-1β and TNF-α in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Baricitinib combined with sulfasalazine in treatment of rheumatoid arthritis is effective, which can effectively reduce the levels of ESR, rheumatoid factors and the level of inflammatory factors, and improve the quality of life of patients.

R976

海南省自然科学基金青年基金项目（820QN400）