CAJ | 학술논문

　　目的探讨英夫利西单抗(Infliximab，商品名：类克，Remcidae)联合甲氨蝶呤(methotrexate，MTX)短期治疗银屑病关节炎(psoriatic arthritis，PsA)的疗效与安全性。方法对传统治疗方案[非甾体类消炎药(NSAIDs)联合MTX或其他免疫抑制剂(DMARDs)]治疗3个月以上疗效欠佳的21例患者，在0、2、6、14周时给予静脉输注Infliximab(剂量为5mg/kg体重，溶于0.9%的氯化钠注射液250ml，输液时间不少于2h)，同时给予MTX 7.5-15mg，1次/周，14周后停用Infliximab，观察患者治疗前后的临床症状、炎性实验室指标的改善情况及药物安全性。结果21例患者关节压痛数、关节肿胀数、银屑病面积和严重度指数(psoriasis area and severity index，PASI)均明显降低，同时血沉(ESR)及C反应蛋白(CRP)亦明显下降，且与治疗前相比差异有统计学意义。1例患者出现注射部位皮肤片状红肿及瘙痒，未予特殊处理后消失，其余患者均未出现明显不良反应。结论Infliximab联合MTX短期治疗银屑病关节炎有效、安全、可行。
　　목적탐토영부리서단항(Infliximab，상품명：류극，Remcidae)연합갑안접령(methotrexate，MTX)단기치료은설병관절염(psoriatic arthritis，PsA)적료효여안전성。방법대전통치료방안[비치체류소염약(NSAIDs)연합MTX혹기타면역억제제(DMARDs)]치료3개월이상료효흠가적21례환자，재0、2、6、14주시급여정맥수주Infliximab(제량위5mg/kg체중，용우0.9%적록화납주사액250ml，수액시간불소우2h)，동시급여MTX 7.5-15mg，1차/주，14주후정용Infliximab，관찰환자치료전후적림상증상、염성실험실지표적개선정황급약물안전성。결과21례환자관절압통수、관절종창수、은설병면적화엄중도지수(psoriasis area and severity index，PASI)균명현강저，동시혈침(ESR)급C반응단백(CRP)역명현하강，차여치료전상비차이유통계학의의。1례환자출현주사부위피부편상홍종급소양，미여특수처리후소실，기여환자균미출현명현불량반응。결론Infliximab연합MTX단기치료은설병관절염유효、안전、가행。
Objective To explore the efficacy and safety of Infliximab combined with methotrexate in short-term treatment of psoriatic arthritis. Methods Twenty-one patients received with 5mg phleb Infliximab which at 0, 2, 6, 14 week and 7.5-15mg oral MTX once a week. Results The swollen joint counts, tenderness joint counts and the score of PASI significantly reduced. Meanwhile the level of ESR and CRP significantly decreased in all cases(P <0.05). One patient experienced pruritus and flaky erythema at the injection site. It disappeared witnout any treatment. No severe adverse effects occurred in other patients. Conclusion The Infliximab combined with methotrexate is effective and safe in short-term treatment of psoriatic arthritis.