托珠单抗对类风湿关节炎患者疗效、免疫球蛋白及辅助性T细胞水平的影响

杜勤; 徐红娣

doi:10.3969/j.issn.1006-0111.201905023

托珠单抗对类风湿关节炎患者疗效、免疫球蛋白及辅助性T细胞水平的影响

doi: 10.3969/j.issn.1006-0111.201905023

杜勤,
徐红娣

浙江省青春医院内科, 浙江杭州 310000

Effects of tocilizumab on the efficacy, immunoglobulin and helper T cells in patients with rheumatoid arthritis

DU Qin,
XU Hongdi

Internal Medicine Department, Zhejiang Youth Hospital, Hangzhou 310000, China

摘要: 目的观察托珠单抗对类风湿关节炎（RA）患者的疗效，以及对患者免疫球蛋白、辅助性T细胞水平的影响。方法选择本院收治的RA患者90例，随机分为对照组与观察组，每组45例。对照组患者接受英夫利西单抗联合甲氨蝶呤治疗方案，观察组患者接受托珠单抗联合甲氨蝶呤治疗方案。两组患者均连续治疗6个月。比较两组患者治疗后的临床疗效；分别检测两组患者治疗前后血清中免疫球蛋白、T辅助细胞-1（T helper1，Th1）以及调节性T细胞（T Regulatory，Treg）的水平。结果治疗后，两组患者晨僵、关节压痛及关节肿胀情况均有所好转，且观察组患者的上述症状情况好转程度明显优于对照组（P<0.05）。两组患者血清中IgG及Th1细胞水平均显著降低，且观察组患者血清中2种细胞水平显著低于对照组（P<0.05）；而两组患者Treg细胞水平均有明显升高，且观察组Treg水平显著高于对照组（P<0.05）。结论托珠单抗可有效改善RA患者临床症状，改善患者免疫功能紊乱，具有较好的临床疗效。
- 托珠单抗 /
- 类风湿关节炎 /
- 免疫蛋白 /
- T辅助细胞 /
- 调节性T细胞
Abstract: Objective To observe the effects of tocilizumab on the efficacy, immunoglobulin and helper T cells in patients with rheumatoid arthritis. Methods 90 patients with rheumatoid arthritis in our hospital were randomly divided into control group and observation group, 45 cases in each group. The patients in the control group were treated with infliximab and methotrexate. The patients in the observation group were treated with tocilizumab and methotrexate. The patients in the two groups were both treated for 6 months. The clinical efficacy of the two groups was compared after treatment. Before and after treatment, the serum levels of immunoglobulin, Th-1 and Treg of patients in two groups were measured. Results The results showed that after treatment, the situation of morning stiffness, joint pressure pain and joint swelling of the patients in the two groups were improved, and the improvement of morning stiffness, joint pressure pain and joint swelling in the observation group was greater (P<0.05). The levels of IgG and Th1 cells in the serum of patients in the two groups significantly decreased, and the levels of IgG and Th1 cells in the serum of the patients in the observation group were significantly lower than that of the control group (P<0.05). The serum level of Treg cells in the serum of patients in the two groups increased significantly, and the level of Treg in the serum of patients in the observation group was significantly higher than that in the control group (P<0.05). Conclusion Topazumab could effectively improve the clinical symptoms of patients with rheumatoid arthritis, and improve the immune dysfunction of the patients with better clinical efficacy.
- tocilizumab /
- rheumatoid arthritis /
- immunoglobulin /
- Th1 /
- Treg

[1]	ZABOTTI A, MANDL P, ZAMPOGNA G, et al. One year in review 2018: ultrasonography in rheumatoid arthritis and psoriatic arthritis[J]. Clin Exp Rheumatol,2018,36(4):519-525
[2]	COHEN S B, ALTEN R, KAMEDA H, et al. A randomized controlled trial comparing PF-06438179/GP1111 (an infliximab biosimilar) and infliximab reference product for treatment of moderate to severe active rheumatoid arthritis despite methotrexate therapy[J]. Arthritis Res Ther,2018,20(1):155
[3]	ALLEVA J M, DIEDRICHS P C, HALLIWELL E, et al. More than my RA: A randomized trial investigating body image improvement among women with rheumatoid arthritis using a functionality-focused intervention program[J]. J Consult Clin Psychol,2018,86(8):666-676
[4]	胡晓敏, 宗英, 余珊珊, 等. 类风湿关节炎治疗药物的研发进展及趋势[J]. 中国新药杂志, 2017, 26(1):36-43
[5]	钱仲华, 孔小阳, 钱唯韵, 等. 舒适护理在老年类风湿关节炎患者中的应用[J]. 实用老年医学, 2016, 30(1):85-86
[6]	张挺, 周艳, 李永吉, 等. 托珠单抗与英夫利西单抗在类风湿关节炎治疗中的疗效评价[J]. 全科医学临床与教育, 2017, 15(3):255-258
[7]	TANAKA Y, KAMEDA H, SAITO K, et al. Effect of subcutaneous tocilizumab treatment on work/housework status in biologic-naïve rheumatoid arthritis patients using inverse probability of treatment weighting: FIRST ACT-SC study[J]. Arthritis Res Ther,2018,20(1):151
[8]	ARNETT F C, EDWORTHY S M, BLOCH D A, et al. The American rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis[J]. Arthritis Rheum,1988,31(3):315-324
[9]	饶莉, 石哲群, 杨静. 痹祺胶囊联合托珠单抗治疗类风湿性关节炎的临床疗效观察[J]. 中药材, 2015, 38(4):866-868
[10]	OTSUKA Y, KIYOHARA C, KASHIWADO Y, et al. Effects of tumor necrosis factor inhibitors and tocilizumab on the glycosylated hemoglobin levels in patients with rheumatoid arthritis; an observational study[J]. PLoS One,2018,13(4):e0196368
[11]	毕东敏, 魏建芬, 张万壮, 等. 麝香乌龙丸对中医不同证型类风湿关节炎血清MIF、ICAM-1、VCAM-1表达的影响[J]. 湖南师范大学学报(医学版), 2016, 13(4):129-132
[12]	CHOY E, CAPORALI R, XAVIER R, et al. Subcutaneous tocilizumab in rheumatoid arthritis: findings from the common-framework phase 4 study programme TOZURA conducted in 22 countries[J]. Rheumatology (Oxford),2018,57(6):1129
[13]	杨洋, 李伟杰, 刘金玉, 等. 托珠单抗单用与联合甲氨蝶呤治疗类风湿性关节炎疗效和安全性比较的Meta分析[J]. 中国药师, 2017, 20(5):854-859
[14]	陈乐锋, 马剑达, 韦秀宁, 等. 托珠单抗联合治疗对难治性类风湿关节炎患者病情活动及心理状态的疗效观察[J]. 中华风湿病学杂志, 2015, 19(2):115-118
[15]	肖雪野. 抗CCP抗体、补体及免疫球蛋白在类风湿性关节炎病理过程中的变化及临床意义[J]. 海南医学院学报, 2017, 23(4):514-517
[16]	刘军慧, 邹蕾, 罗妍. TCZ联合IMD治疗RRA的疗效和对ESR、CRP、IgG水平的影响[J]. 西南国防医药, 2018, 28(5):406-409
[17]	罗小红, 周娟, 洪学志, 等. 青蒿治疗难治性类风湿关节炎患者的疗效及对TH17/Treg细胞因子的影响[J]. 中国医院药学杂志, 2017, 37(24):2451-2455

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托珠单抗对类风湿关节炎患者疗效、免疫球蛋白及辅助性T细胞水平的影响

doi: 10.3969/j.issn.1006-0111.201905023

Effects of tocilizumab on the efficacy, immunoglobulin and helper T cells in patients with rheumatoid arthritis

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托珠单抗对类风湿关节炎患者疗效、免疫球蛋白及辅助性T细胞水平的影响

doi: 10.3969/j.issn.1006-0111.201905023

浙江省青春医院内科, 浙江杭州 310000

English Abstract

Effects of tocilizumab on the efficacy, immunoglobulin and helper T cells in patients with rheumatoid arthritis

Internal Medicine Department, Zhejiang Youth Hospital, Hangzhou 310000, China

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托珠单抗对类风湿关节炎患者疗效、免疫球蛋白及辅助性T细胞水平的影响

doi: 10.3969/j.issn.1006-0111.201905023

Effects of tocilizumab on the efficacy, immunoglobulin and helper T cells in patients with rheumatoid arthritis

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托珠单抗对类风湿关节炎患者疗效、免疫球蛋白及辅助性T细胞水平的影响

doi: 10.3969/j.issn.1006-0111.201905023

浙江省青春医院内科, 浙江 杭州 310000

English Abstract

Effects of tocilizumab on the efficacy, immunoglobulin and helper T cells in patients with rheumatoid arthritis

Internal Medicine Department, Zhejiang Youth Hospital, Hangzhou 310000, China

全文HTML

目录

浙江省青春医院内科, 浙江杭州 310000