【摘要】 目的 探究甲氨蝶呤联合维生素D治疗银屑病关节炎的临床效果及其对患者免疫因子水平的影响。方法 选取2021年1月—2024年1月收治的98例银屑病关节炎患者作为研究对象，回顾性收集其临床资料，根据治疗方法不同分为对照组和观察组，每组49例。对照组给予甲氨蝶呤治疗，观察组在对照组治疗的基础上联合维生素D治疗。比较2组连续治疗12周后的效果。结果 观察组的治疗总有效率显著高于对照组（95.92%vs. 81.63%）,P<0.05;观察组治疗12周后的关节压痛数量、关节肿胀数量、银屑病皮损情况评分（psoriasis area and severity index,PASI）、晨僵时间、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-1β(interleukin-1β,IL-1β)、自然杀伤（natural killer,NK）细胞和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平均降低，且明显低于对照组（P<0.05）;观察组治疗4、8、12周后的视觉模拟疼痛评分量表（visual analogue scale,VAS）评分均显著低于对照组（P<0.05），慢性病管理自我能效量表评分显著高于对照组（P<0.05）;观察组治疗12周后的关节炎生活质量测量量表2-简表（arthritis impact measurement scales 2-short form,AIMS2-SF）各维度评分均显著高于对照组（P<0.05）。结论 甲氨蝶呤联合维生素D可减轻银屑病关节炎患者的临床症状和体征，降低免疫因子水平，有效缓解患者的疼痛感，提高患者的生活质量及自我能效感，且安全性较高。更多还原

【Abstract】 Objective To investigate the clinical efficacy of methotrexate combined with vitamin D in treating psoriatic arthritis and its impact on immune factor levels. Methods A retrospective study was conducted on 98 patients with psoriatic arthritis admitted to our hospital from January 2021 to January 2024. The patients were divided into 2 groups based on their treatment methods: the control group(49 cases) received methotrexate treatment, while the observation group(49 cases) received methotrexate combined with vitamin D. The therapeutic outcomes of both groups were compared after 12 weeks of continuous treatment. Results The total effective rate of treatment was significantly higher in the observation group(95.92%) than in the control group(81.63%), P<0.05. After 12 weeks of treatment, the number of tender joints, swollen joints, psoriasis area and severity index(PASI), morning stiffness duration, interleukin-6(IL-6), interleukin-1β(IL-1β), natural killer(NK) cells, and tumor necrosis factor-α(TNF-α) levels were significantly lower in the observation group than in the control group(P<0.05). The visual analogue scale(VAS) scores of the observation group were significantly lower than those of the control group at 4, 8, and 12 weeks of treatment(P<0.05). The chronic disease management self-efficacy scale scores were significantly higher in the observation group than in the control group(P<0.05). The quality of life, as measured by the arthritis impact measurement scales 2-short form(AIMS2-SF) scale, was significantly better in the observation group across all dimensions after 12 weeks of treatment(P<0.05). Conclusion The combination of methotrexate and vitamin D effectively alleviates clinical symptoms and signs in patients with psoriatic arthritis, reduces immune factor levels, effectively relieves pain, improves quality of life and self-efficacy, and is relatively safe.更多还原