CAJ | 학술논문

目的探讨甲氨蝶呤、柳氮磺吡啶、硫酸羟氯喹联合治疗类风湿关节炎（rheumatoid arthritis， RA）患者对血脂的影响．方法选取2009年11月至2010年11月云南省第一人民医院风湿科门诊和住院的RA患者68例，随机分为A、B两组，每组34例．A组联合应用甲氨蝶呤、柳氮磺吡啶、硫酸羟氯喹联合治疗RA，B组在A组治疗基础上加用血脂康．分别观察2组RA患者在治疗前及治疗6个月后胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、关节肿胀指数、关节压痛指数、晨僵时间、C-反应蛋白（CRP）、血沉（ESR）、DAS28．结果经6个月治疗后，两组患者TC、TG、LDL-C均低于治疗前，而HDL-C高于治疗前，经统计学分析，差异有统计学意义（P＜0.05或P＜0.01）；治疗6个月后，2组R患者DAS28、ESR、CRP、关节压痛数、关节肿胀数和晨僵时间与治疗前比较明显降低，差异有统计学意义（P＜0.01）．两组治疗后相比较上述指标均无统计学意义（P＞0.05）．结论 RA患者存在血脂水平异常，慢作用抗风湿药在缓解患者关节病情同时，对于患者的血脂有一定的影响．
목적탐토갑안접령、류담광필정、류산간록규연합치료류풍습관절염（rheumatoid arthritis， RA）환자대혈지적영향．방법선취2009년11월지2010년11월운남성제일인민의원풍습과문진화주원적RA환자68례，수궤분위A、B량조，매조34례．A조연합응용갑안접령、류담광필정、류산간록규연합치료RA，B조재A조치료기출상가용혈지강．분별관찰2조RA환자재치료전급치료6개월후담고순（TC）、저밀도지단백담고순（LDL-C）、감유삼지（TG）、고밀도지단백담고순（HDL-C）、관절종창지수、관절압통지수、신강시간、C-반응단백（CRP）、혈침（ESR）、DAS28．결과경6개월치료후，량조환자TC、TG、LDL-C균저우치료전，이HDL-C고우치료전，경통계학분석，차이유통계학의의（P＜0.05혹P＜0.01）；치료6개월후，2조R환자DAS28、ESR、CRP、관절압통수、관절종창수화신강시간여치료전비교명현강저，차이유통계학의의（P＜0.01）．량조치료후상비교상술지표균무통계학의의（P＞0.05）．결론 RA환자존재혈지수평이상，만작용항풍습약재완해환자관절병정동시，대우환자적혈지유일정적영향．
Objective To observe the effect of combination therapies with methotrexate, sulfasalazine and hydroxychloroquine on hyperlipemia of rheumatoid arthritis.Method From 2009 November to 2010 November, 68 RA inpatients and outpatients in the department of rheumatism of our hospital were randomly divided into two groups: A group and B group, 34 cases in each group. The patients in A group were given combination of methotrexate, sulfasalazine, hydroxychloroquine sulfate for the treatment of RA,patients in B group, based on A group's treatment, were treated by xuezhikang. Some indexes were observed in two group before treatment and 6 months after treatment, including cholesterolTC,low density lipoprotein cholesterol LDL-C , triglyceride TG , high density lipoprotein cholesterol HDL-C , swelling index, joint pain index, time of morning stiffness, C-reactive protein CRP , erythrocyte sedimentation rate ESR and DAS28. Results After 6 months’ treatment, the serum levels of TC, TG,, LDL-C, both in two groups of patients, were lower than those before treatment, and HDL-C was higher than that before treatment, there were significant differences (P<0.05 or P<0.01) . After 6 months of treatment,DAS28,ESR,CRP,joint tenderness,joint swelling and morning stiffness time, both in two groups RA patients, significantly reduced compared with before treatment, there were a very significant difference (P<0.05 or P<0.01) .After treatment, the above indexes had no statistically significant difference between two groups (P>0.05) . Conclusion RA patients have abnormal blood lipid levels, disease-modifying anti-rheumatic drugs have effect on blood lipid during remission joint disease in RA patients.