环磷酰胺冲击联合甲氨喋呤治疗类风湿性关节炎52例远期疗效分析

目的为了观察应用环磷酰胺（CTX）冲击联合甲氨喋呤（MTX）治疗类风湿性关节炎（RA）的远期疗效。方法我科自1992年起应用环磷酰胺冲击联合甲氨喋呤治疗类风湿性关节炎52例进行了为期一年的疗效观察，RA患者在治疗后8周检测晨但时间、20m步行时间、握力、关节病变数、ESR、CRP、γ-球蛋白、IgG、IgM、IgA、RF等项目，并对治疗半年～1年后关节X线照片进行观察。结果发现应用CTX合MTX治疗RA有较好疗效，副作用亦较少，治疗前后上述各项指标对比有极显著差异（P＜0.01）。通过观察半年～1年后x光对比发现RA患者关节损害无明显改变。结论应用CTX冲击合MTX治疗RA能控制RA病情发展，对关节滑膜及骨质破坏起到较好保护作用。

Long term effectiveness of CTX and MTX in treating 52 patients with rheumatoid arthritis

Objective To evaluate the long-term effectiveness of CTX and MTX in treating patients with rheumatoid arthritis (RA).Methods Treated patients with RA with CTX and MTX. Fifty-two patients were observed within one year. Morning stiffoess span,twenty-mile-walking-time, grip strength, the total joint count, the erythrocyte sedimentation rate (ESR), the C-reactive protein (CRP),gamma globulin, IgG, IgM, IgA and the rheumatoid factor (RF) were measured after 8 week's treatment. The X-ray was taken tostudy the changes in arthrosis after half to one year. Results CTX and Mry hed good long term effectiveness and no side effects onpatients with RA. CTX and MTX had significant effect on all controlled parameters compared to pre-treatment values, and nosignificant radiological deterioration was observed. Conclusion CTX and MTX combined with TCM could control the developmentof RA and limit the development of joint damage.