目的 探究阿达木单抗注射液联合艾拉莫德治疗类风湿关节炎的临床效果。方法 选取2019年4月—2023年4月在马鞍山市人民医院进行治疗的类风湿性关节炎患者81例，根据患者治疗方案差异将患者分成对照组（40例）和治疗组（41例）。对照组饭后口服艾拉莫德片，25 mg/次，2次/d；治疗组在对照组基础上皮下注射阿达木单抗注射液，40 mg/次，1次/2周。两组患者均进行12周的治疗。观察两组患者临床疗效，比较治疗前后两组患者WHOQOL-BREF和VAS评分，临床症状改善时间，血清炎性因子白介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、γ-干扰素（IFN-γ）、脂联素（ADPN）、降钙素基因相关肽（CGRP）和Ⅱ型胶原C端肽（CTX-Ⅱ）水平。结果 治疗后，对照组和治疗组临床总有效率分别为80.00%、95.12%，两组比较差异具有统计学意义（P＜0.05）。治疗后，两组患者VAS评分显著下降，而WHOQOL-BREF评分显著上升（P＜0.05），且治疗组患者WHOQOL-BREF和VAS评分明显好于对照组（P＜0.05）。治疗后，治疗组患者关节晨僵、关节肿胀、关节疼痛和关节活动受限症状改善时间均明显短于对照组（P＜0.05）。治疗后，两组患者血清炎性因子IL-1β、TNF-α、IFN-γ和CTX-Ⅱ水平显著降低，而ADPN和CGRP水平显著升高（P＜0.05），且治疗组血清指标改善明显好于对照组（P＜0.05）。结论 阿达木单抗注射液联合艾拉莫德片治疗类风湿关节炎疗效显著，不仅能够显著改善患者临床症状、炎症因子水平和生存质量，同时还能够促进血清学指标的恢复且并未增加明显不良反应。

Objective To investigate the clinical effect of Adalimumab Solution for injection combined with iguratimod in treatment of rheumatoid arthritis. Methods Patients (81 cases) with rheumatoid arthritis in Ma’anshan People’s Hospital from April 2019 to April 2023 were divided into control (40 cases) and treatment (41 cases) group based on different treatments. Patients in the control group were po administered with Iguratimod Tablets after meals, 25 mg/time, twice daily. Patients in the treatment group were subcutaneous injection administered with Adalimumab Solution for injection on the basis of the control group, 40 mg/time, once every 2 weeks. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluations were evaluated, the scores of WHOQOL-BREF and VAS, the improvement time of clinical main symptoms, the levels serum inflammatory factor IL-1β, TNF-α, IFN-γ, ADPN, CGRP and CTX-Ⅱ in two groups before and after treatment were compared. Results After treatment, the clinical effective rates in the control group and the treatment group were 80.00% and 95.12% respectively, and the difference between two groups was statistically significant (P < 0.05). After treatment, the VAS scores in two groups were significantly decreased, while the WHOQOL-BREF were scores significantly increased (P < 0.05), and the WHOQOL-BREF and VAS scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the improvement time for morning stiffness, joint swelling, joint pain and limited joint activity in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the levels of serum inflammatory factors IL-1β, TNF-α, IFN-γ and CTX-Ⅱ were significantly reduced in two groups, while the levels of ADPN and CGRP were significantly increased (P < 0.05), and the improvement of serum indicators in the treatment group was significantly better than that in the control group (P < 0.05). Conclusion Adalimumab Solution for injection combined with Iguratimod Tablets has significant efficacy in the treatment of rheumatoid arthritis, which can not only significantly improve the clinical symptoms, inflammatory factor levels and quality of life, but also promote the recovery of serological indicators without increasing significant adverse reactions.

R977

安徽省自然科学基金资助项目（2008085QH386）