目的 探讨阿达木单抗联合甲氨蝶呤和硫酸羟氯喹治疗类风湿关节炎的临床疗效。方法 选取2022年1月—2024年2月安徽医科大学附属宿州医院收治的100例类风湿关节炎患者。依据用药情况分为对照组（50例）和治疗组（50例）。对照组患者口服甲氨蝶呤片10 mg/次，1次/周，同时口服硫酸羟氯喹片0.2 g/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。两组患者连续用药12周。观察两组患者临床疗效，比较治疗前后两组患者类风湿简化疾病活动指数（SDAI）评分和生活质量量表（QLQ-C30）评分，免疫因子指标免疫球蛋白G（IgG）、免疫球蛋白M（IgM）和类风湿因子（RF）及炎性因子指标白细胞介素-17（IL-17）、肿瘤坏死因子-α（TNF-α）和IL-6水平。结果 治疗后，治疗组临床总有效率为94.00%，明显高于对照组的78.00%（P＜0.05）。治疗后，两组患者SDAI评分降低明显，QLQ-C30评分均高于治疗前（P＜0.05），且治疗组SDAI评分和QLQ-C30评分明显好于对照组（P＜0.05）。治疗后，两组患者IgG、IgM、RF、IL-17、TNF-α和IL-6指标水平均低于治疗前（P＜0.05），且治疗组指标水平均明显低于对照组（P＜0.05）。结论 阿达木单抗联合甲氨蝶呤和硫酸羟氯喹治疗类风湿关节炎，能够有效改善患者的病情，减轻其疼痛症状，并能有效降低炎症因子，患者的生活质量有所改善。

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

安徽省重点研究与开发计划项目(202104j07020054)