依那西普用于强直性脊柱炎前期治疗66例及后续治疗方案的选择

依那西普用于强直性脊柱炎前期治疗66例及后续治疗方案的
选择
胡海锦
【期刊名称】《中国药业》
【年(卷),期】2014(000)023
【摘要】Objective To investigate the efficacy of etanercept in the treatment of ankylosing spondylitis (AS) and the application value of thalidomide combined with sulfasalazine in its subsequent therapy. Methods 66 cases of AS in our hospital from march 2010 to march 2013 were randomly divided into the group A, B and C. All the patients in 3 groups were treated with etanercept for 3 months;then the group A, B and C were given thalidomide, sulfasalazine and thalidomide combined with sulfasalazine for 3 - month subsequent therapy respectively. The changes of the Bath Ankylosing Spondylitis Disease Activity IndeX (BASDAI) score, Bath Ankylosing Spondylitis Functional IndeX (BASFI) score, erythrocyte sedimentation rate (ESR) and C - reactive protein (CRP) before and after treatment were observed, and the reaction standard recommended by AS Assessment Working group (ASAS) was used to evaluate clinical reactions of patients and the proportion of the patients reaching ASAS20 after treatment were recorded. Results After 3 - month treatment, the BAS-DAI score, BASFI score, ESR and CRP in the three groups were decreased compared with before treatment( P < 0. 05), but the BASDAI score, BASFI
score, ESR and CRP had no statistically significant differences among the three groups( P > 0. 05); after 5, 6 months treat-ment, the BASDAI score, BASFI score, ESR and CRP of the group C were significantly lower than those of the group A and B with statistical differences( P < 0. 05) . After etanercept treatment for three months, the proportions of the patients reaching ASAS 20 in the three groups were all 100% , but then after 3 - month different subsequent therapies, the proportion of the group A and B reaching ASAS 20 was significantly decreased, the proportion of group C was significantly higher than that of the group A and B, the difference was statistically significant( P < 0. 05) . Conclusion Etanercept has better efficacy in short - term treatment of AS and can relieve the clinical symptoms quickly and effectively, but the eXpensive price limits its long - term use; in the subsequent therapy, the combination therapy of thalidomide and sulfasalazine can effectively control the symptoms, its effect is significantly better than that of thalidomide or sulfasalazine alone, and its security and tolerance are well, which is worthy of clinical application.%目的：观察依那西普治疗强直性脊柱炎（AS）的疗效及沙利度胺联合柳氮磺吡啶在后续治疗中的应用价值。

方法选择医院2010年3月至2013年3月收治的强制性脊柱炎患者66例，随机分为 A，B，C 3组。

3组患者均给予依那西普治疗3个月；A 组后续治疗采用沙利度胺，B 组后续治疗采用柳氮磺吡啶治疗，C 组后续治疗采用沙利度胺联合柳氮磺吡啶，均后续治疗3个月。

观察3组患者治疗前后强直性脊柱炎症评分（BASDAI）、巴氏强直性脊柱炎功能指数（BASFI）、血沉（ESR）和 C 反应蛋白（CRP）变化情况，并采用 AS 评定工作组（ASAS）推荐的反应标准评价患者的临床反应，统计治疗后达 ASAS 20的患
者比例。

结果3组患者治疗3个月时 BASDAI， BASFI，ESR，CRP 均较治疗前
降低（ P <0.05），但3组间比较，差异无统计学意义（ P >0.05）；治疗后5，6个月时 C 组 BASDAI，BASFI， ESR，CRP 明显低于 A，B 组（ P <0.05）。

3组患者依那西普治疗3个月时，临床反应评价达ASAS 20的患者比例均为100%，但采用不同后续治疗3个月后，A，B 组患者临床反应评价达 ASAS 20的患者比
例明显降低，C 组 ASAS 20患者比例明显高于 A，B 组（ P <0.05）。

结论依那
西普短期应用治疗 AS 患者效果较好，能迅速有效缓解患者临床症状，但价格昂贵限制了其长期使用；后续治疗中采用沙利度胺、柳氮磺吡啶联合治疗能有效控制患者症状，效果明显优于单用沙利度胺或柳氮磺吡啶，安全性和耐受性较好，值得临床应用。

【总页数】3页(P39-40,41)
【作者】胡海锦
【作者单位】山东省东营鸿港医院，山东东营 257000
【正文语种】中文
【中图分类】R969.4;R977.6
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