甲氨蝶呤治疗银屑病性关节炎临床观察_朱立娟.pdfVIP

38 北方药学2012 年第9 卷第7 期 甲氨蝶呤治疗银屑病性关节炎临床观察 朱立娟 纳世丽（四川省攀枝花市中心医院风湿科 攀枝花 617000） 摘要：目的：观察甲氨蝶呤治疗银屑病性关节炎的疗效及不良反应。方法：选符合标准的该病患者59 例，随机分为两组。治疗组 予甲氨蝶呤治疗，对照组仅用维A 酸类药物外用。结果：治疗组治愈ll 例，显效9 例，好转8 例，无效4 例，总有效率为87.5％ （95％CI=65.6～97.8％）；对照组治愈2 例，显效6 例，好转5 例，无效 14 例，总有效率为48.1％ （95％CI=29.3～66.9％）；两组综合疗 效比较（Ⅱ=3.2531，P=0.0015），差异显著。结论：甲氨蝶呤治疗银屑病关节炎的临床疗效明显优于外用维A 酸类药物，其收益 OR=0.13 （95％CI=0.04～0.47），NNT=3 （95％CI=1.35～3.54）。 关键词：甲氨蝶呤 银屑病 维A 酸类药物 中图分类号：R684.3 文献标识码：B 文章编号：1672-8351（2012）07-0038-02 Clinical observation of Methotrexate in the treatment of Psoriatic Arthritis Zhu Lijuan Na Shili （Department of the Central Hospital of Panzhihua City ，Panzhihua China 617000） Abstract ：Objective:To observe the curative effect of therapy of Methotrexate on psoriatic arthritis．Method ：59 cases of sick children suffered from psoriatic arthritis were divided into twogroups randomly．ne treatment group Was treated by Methotrexate．anther control group Was treated by topical tretinoin．Result ：In the treatment group ll cases were cured ，9cases were excellent．8 cases were effective and 4 cases were ineffective．The total effective rate Was 87.5％ （95％ CI=65.6 ～97.8％）．In the control group 2 cases were cured ，6 cases were excellent ，5 cases were effectiveand 14 cases were ineffective．The total effective rate was 48.1％ （95％ CI=29.3 ～66.9％）. Thedifference between the two groups Was significant （H=3.2531，P =0.0015）．Conclusion ：ne curative effect of Methotrexate with on psoriatic arthritis is better than that of topical tretinoin．OR=0．13 （95％CI=0.04～0.47），NNT=3 （95％C11.35～3.54）． Key word ：Methotrexate Psoriatic Arthritis Topical tretinoin 银屑病关节炎（PA）是一种与银屑病（牛皮癣）有关的炎性 退，无活动痛，功能恢复至病前水平，关节畸形可无改善；显 关节病，病理改变主要为炎性滑膜炎，病程迁延，易复发，晚期 效：PASI 变化值61～90％ ，关节红肿消退，活动时偶有疼痛；好 可出现关节强直而致残。据调查，银屑病的发病率为1.23％，且 转：PASI 变化值31～60％ ，关节红肿疼痛改善；无效：PASI 变化