多聚谷氨酸化甲氨蝶呤浓度与类风湿关节炎疗效相关性研究

罗彦; 王志中; 王勇; 牟方祥; 吴红; 方勇飞; 万萍

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多聚谷氨酸化甲氨蝶呤浓度与类风湿关节炎疗效相关性研究

论著 | 更新时间：2025-01-15

- 多聚谷氨酸化甲氨蝶呤浓度与类风湿关节炎疗效相关性研究
- Correlation of methotrexate polyglutamate concentration in erythrocyte with methotrexate efficacy in rheumatoid arthritis patients
- 陆军军医大学学报 2011年33卷第5期页码：473-476
- 作者机构：
  
  第三军医大学西南医院中西医结合科
- 作者简介：
- 基金信息：
- DOI：
  中图分类号： R976;R969.4;R593.22
- 纸质出版日期：2011，
  
  网络出版日期：2011-03-15，
- 稿件说明：
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罗彦, 王志中, 王勇, 等. 多聚谷氨酸化甲氨蝶呤浓度与类风湿关节炎疗效相关性研究[J]. 陆军军医大学学报, 2011,33(5):473-476.

LUO YAN, WANG ZHIZHONG, WANG YONG, et al. Correlation of methotrexate polyglutamate concentration in erythrocyte with methotrexate efficacy in rheumatoid arthritis patients. [J]. Journal of army medical university, 2011, 33(5): 473-476.
罗彦, 王志中, 王勇, 等. 多聚谷氨酸化甲氨蝶呤浓度与类风湿关节炎疗效相关性研究[J]. 陆军军医大学学报, 2011,33(5):473-476. DOI：

LUO YAN, WANG ZHIZHONG, WANG YONG, et al. Correlation of methotrexate polyglutamate concentration in erythrocyte with methotrexate efficacy in rheumatoid arthritis patients. [J]. Journal of army medical university, 2011, 33(5): 473-476. DOI：

摘要

目的探讨经甲氨蝶呤(methotrexate

MTX)治疗的类风湿关节炎(rheumatoid arthritis

RA)患者红细胞内多聚谷氨酸化甲氨蝶呤(methotrexate polyglutamate

MTXPG)的浓度与其疾病活动度的关系。方法选取76例经MTX治疗3个月的RA患者进行横断面研究，采用ELISA方法检测红细胞内MTXPG浓度，根据治疗后疾病活动度（DAS28）以及治疗前后DAS28差异性分值分为显效、有效和无效组，进行各组之间MTXPG浓度的比较及相关性分析。结果经MTX治疗后21例RA患者显效，41例有效，14例无效。显效组红细胞内MTXPG浓度为(158.87±48.27）ng/ml，显著高于有效组(105.89±24.23)ng/ml及无效组(85.80±21.30)ng/ml (

0.01)。红细胞内MXPG浓度与CRP(

=-0.628

P=0.000)、晨僵时间(

=-0.396

=0.000)、肿胀关节数(

=-0.321，

=0.005)、压痛关节数(

=-0.376，

=0.001)、视觉模拟评分(VAS) (

=-0.236

P=0.000)、DAS(

=-0.255，

=0.026)呈显著负相关；与血沉、健康问卷评分(HAQ)无相关性(

>0.05)。结论经MTX治疗的RA患者各疗效组间红细胞内MTXPG浓度差异显著，较高浓度的MTXPG与较好的临床疗效相关。

Abstract

Objective To investigate the correlation between the disease activity and methotrexate polyglutamate (MTXPG) concentration in the erythrocytes of rheumatoid arthritis (RA) patients treated with methotrexate (MTX). Methods Seventy-six cases of RA patien

treated with MTX for 3 months

were selected for the cross-sectional study. MTXPG concentrations in the erythrocytes of RA patients were measured by ELISA. The seventy-six cases were divided into a remarkably effective group

an effective group and an ineffective group based on disease activity score (DAS28) after treatment as well as DAS28 difference before and after treatment. MTXPG concentrations were compared among the above groups

and their correlation with MTX efficacy on RA was analyzed. Results The numbers of RA patients in the remarkably effective group

effective group and ineffective group were 21

41 and 14

respectively. MTXPG concentrations in the erythrocytes of the remarkably effective group were 158.87±48.27 ng/ml

significantly higher than those of the effective group (105.89±24.23 ng/ml) and ineffective group (85.80±21.30 ng/ml) (

0.01). MTXPG concentrations were negatively related to CRP (

=-0.628

=0.000)

time of morning stiffness (

=-0.396

=0.000)

swollen joint count (

=-0.321

=0.005)

tender joint count (

=-0.376，

=0.001)

visual analogue scale (

=-0.236

=0.000)

and DAS (

=-0.255，

=0.026). However

there was no correlation between MTXPG concentrations and blood sedimentation or health assessment questionnaire (

>0.05). Conclusion MTXPG concentrations in the erythrocytes are significantly different in the remarkably effective group

effective group and ineffective group of RA patients treated with MTX. The higher the MTXPG level

the better the clinical efficacy.

关键词

类风湿关节炎甲氨蝶呤多聚谷氨酸化甲氨蝶呤

Keywords

rheumatoid arthritismethotrexatemethotrexate polyglutamate

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