【摘要】 目的 探讨托法替布联合甲氨蝶呤(MTX)在传统改变病情抗风湿药(DMARDs)治疗未达标类风湿性关节炎(RA)患者中的应用效果及安全性。方法 选取2021年1月至2022年9月中山市小榄人民医院收治的60例RA患者，随机分为对照组和研究组，每组30例。对照组接受注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白联合MTX治疗，研究组接受托法替布联合MTX治疗，均持续治疗6个月。观察记录两组临床疗效、临床症状、ERS、CRP及IL-6水平、DAS 28及HAQ评分。结果 研究组ACR 20、ACR 50、ACR 70比较，P>0.05。治疗后6个月，研究组晨僵时间短于对照组，TJC和SJC均少于对照组，ERS、CRP和IL-6水平、DAS 28与HAQ评分均低于对照组，P<0.05。结论 托法替布联合MTX治疗传统DMARDs治疗未达标的RA患者，可有效缓解其临床症状，减轻关节功能障碍和炎症反应。更多还原

【Abstract】 Objective:To explore the application effect and safety of tofacib combined with methotrexate(MTX) in the treatment of substandard rheumatoid arthritis(RA) patients with traditional disease-changing anti-rheumatic drugs(DMARDs). Methods:From January 2021 to September 2022, 60 patients with RA admitted to Xiaolan People’s Hospital in Zhongshan City were randomly divided into control group and research group, with 30 patients in each group. The control group was treated with recombinant human tumor necrosis factor receptor-antibody fusion protein for injection combined with MTX,and the research group was treated with tofacib combined with MTX,both of which continued for 6 months. The clinical efficacy、clinical symptoms、ERS、CRP and IL-6 levels、DAS 28 and HAQ scores of the two groups were observed and recorded.Results:ACR 20、ACR 50 and ACR 70 in the study group were compared, P>0.05. Six months after treatment, the morning stiffness time、TJC and SJC of the study group were shorter than those of the control group, and the levels of ERS、CRP and IL-6、DAS 28 and HAQ were lower than those of the control group, P<0.05. Conclusion:Tofatib combined with MTX can effectively relieve the clinical symptoms, joint dysfunction and inflammatory reaction of RA patients who fail to meet the standard of traditional DMARDs treatment.更多还原