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目的 分析糖皮质激素治疗类风湿关节炎(RA)的临床效果及对类风湿关节炎转归的影响,提高对糖皮质激素治疗类风湿关节炎的认识。方法 回顾性分析了1999年1月至2003年3月北京协和医院门诊有随访记录的300例类风湿关节炎患者的临床资料,将治疗初期即使用改善病情抗风湿药的227例患者分为糖皮质激素治疗组(89例)和非糖皮质激素治疗组(138例),比较两组患者疾病临床缓解和远期关节X线变化的差异,比较糖皮质激素治疗组中不同剂量间的近期、远期疗效及不同疗程的远期疗效。结果 两组近期疗效总有效率分别为86 .5%、66 .0% (P<0. 05),起效时间分别为(3 5±1 6)、(5 4±1 9)周(P<0 .05);糖皮质激素治疗组中不同剂量间的近期疗效、远期疗效及不同疗程的远期疗效差异均无统计学意义(P>0 .05)。结论 糖皮质激素对于活动性类风湿关节炎患者能较快、明显地改善疾病活动程度,但未见对类风湿关节炎骨侵蚀有控制作用。不同初始治疗剂量及疗程对近期改善类风湿关节炎疾病活动度和控制其骨破坏未见差异。
Objective To analyze the clinical effect of glucocorticoid on rheumatoid arthritis (RA) and its effect on the outcome of rheumatoid arthritis and to improve the cognition of glucocorticoid on rheumatoid arthritis. Methods The clinical data of 300 patients with rheumatoid arthritis who were followed up at Peking Union Medical College Hospital from January 1999 to March 2003 were retrospectively analyzed. The 227 patients with improvement of disease antirheumatic drugs were divided into three groups Corticosteroid treatment group (n = 89) and non-glucocorticoid treatment group (n = 138). The differences of clinical remission and long-term joint X-ray changes between the two groups were compared and the differences between the different dosages in the glucocorticoid treatment group were compared. Long-term efficacy and long-term efficacy of different courses. Results The total effective rates of the two groups were 86.5% and 66.0%, respectively (P <0.05), and the onset time was (35 ± 16) and (54 ± 19) weeks <0.05). There was no significant difference in short-term efficacy, long-term efficacy and long-term efficacy of different courses between different dosages in glucocorticoid therapy group (P> 0.05). Conclusion Glucocorticoids in patients with active rheumatoid arthritis can be faster and significantly improve the degree of disease activity, but no effect on rheumatoid arthritis bone erosion control. Different initial treatment dose and course of treatment for the recent improvement of rheumatoid arthritis disease activity and control of bone destruction no difference.