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益赛普治疗强直性脊柱炎临床观察及疗效评估摘要目的：评价重组人Ⅱ型肿瘤坏死因子受体Fc抗体融合蛋白(益赛普)治疗强直性脊柱炎(AS)的疗效和安全性。
方法：30例活动性强直性脊柱炎(AS)患者，随机分为治疗组15例和对照组15例，治疗组应用益赛普治疗，对照组应用(双氯芬酸钠+柳氮磺胺吡啶+甲氨蝶呤)治疗24周，分别在第0、6、14、24周评价两组的临床疗效和安全性。
观察指标为ASAS(20、50、70)、脊柱痛、晨僵时间、胸廓扩张度、脊柱侧弯、C反应蛋白(CRP)、红细胞沉降率(ESR)等。
结果治疗组患者治疗后ASAS(20、50、70)、脊柱痛、胸廓扩张度、脊柱侧弯、CRP、ESR等指标较治疗前均明显改善，差异均有统计学意义(均P＜0.05)。
对照组患者治疗后脊柱痛、晨僵时间及CRP、ESR均较治疗前明显改善，差异均有统计学意义(均P＜0.05)，但(ASAS20、50、70)、胸廓扩张度、脊柱侧弯、踝间距治疗前后的差异无统计学意义。
两组间比较，治疗组各项观察指标改善程度明显优于对照组，差异有统计学意义(P＜0.05)。
治疗组不良反应发生率(13.3%)明显低于对照组(40.0%)，差异有统计学意义(P＜0.05)。
结论：益赛普治疗活动性AS疗效显著，能改善AS患者的症状、体征、关节功能和生活质量，并具有良好的安全性。
关键词强直性脊柱炎TNF-α 益赛普强直性脊柱炎是一种慢性进行性疾病，主要侵犯骶髂关节，脊柱骨突，脊柱旁软组织及外周关节，并可伴发关节外表现。
严重者可发生脊柱畸形和关节强直。
目前本病缺乏有效治疗药物，致残率高，传统的慢作用药柳氮磺胺吡啶、甲氨蝶呤、沙利度胺加非甾体类抗炎药有一定的作用，但上述药物均没有令人信服的证据证明对脊柱病变有作用［1］，对上述药物无效或难以耐受患者基本上就没有药物可选择了。
TNF-a在免疫反应中具有介导炎症和免疫调节作用，其效应包括激活淋巴细胞、释放其他细胞因子、前列腺素和金属蛋白酶；也可以促进血管形成和调节黏附分子作用。
益赛普组合柳氮磺吡啶在强直性脊柱炎中的疗效观察
陈永强
【期刊名称】《北方药学》
【年(卷),期】2016(013)011
【摘要】目的:探究益赛普组合柳氮磺吡啶在强直性脊柱炎中的疗效.方法:将我院收治的56例强直性脊柱炎患者随机分为对照组和观察组.对照组采用柳氮磺吡啶单独治疗,观察组采用益赛普组合柳氮磺吡啶治疗.对比分析两组临床治疗效果.结果:观察组临床治疗效果明显优于对照组,差异具有统计学意义(P<0.05).结论:益赛普组合柳氮磺吡啶在强直性脊柱炎治疗中效果显著,能够有效降低患者的C反应蛋白、肿瘤坏死因子a以及血清中血沉的水平,值得在临床上推广.
【总页数】2页(P11-12)
【作者】陈永强
【作者单位】广州市番禺区中医院广州 510000
【正文语种】中文
【中图分类】R593.23
【相关文献】
1.益赛普、柳氮磺吡啶联合功能锻炼治疗强直性脊柱炎效果系统评价 [J], 杨润薇
2.益赛普、柳氮磺吡啶联合功能锻炼治疗强直性脊柱炎临床观察 [J], 庄铭城;庄俊合;李明智
3.益赛普联合柳氮磺吡啶对强直性脊柱炎患者腰椎功能的改善研究 [J], 李陶冉;史丽璞
4.益赛普联合柳氮磺吡啶治疗强直性脊柱炎疗效及miR-29a、miR-146a的变化[J], 张诺; 郭明蔚; 陈桂武; 李刚
5.益赛普联合柳氮磺吡啶治疗强直性脊柱炎的疗效及对血清中IL-1和TNF-α的影响 [J], 李萍;孙敏
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DOI：10.16662/ki.1674-0742.2023.14.134益赛普联合柳氮磺吡啶治疗强直性脊柱炎的疗效及对血清中IL-1和TNF-α的影响张彩凤无锡市惠山区人民医院风湿免疫科，江苏无锡214187［摘要］目的探讨强直性脊柱炎患者联用益赛普与柳氮磺吡啶治疗的疗效及其对血清IL-1和TNF-α水平的影响。
方法随机选择2021年1月—2022年6月无锡市惠山区人民医院收治的强直性脊柱炎100例为研究对象，随机分为单用柳氮磺吡啶治疗的对照组与益赛普联合柳氮磺吡啶治疗的研究组，每组50例。
评估两组临床疗效、腰背疼痛评分（VAS）、强直性脊柱炎活动指数（BASDAI）、强直性脊柱炎功能指数（BASFI）、CRP、TNF-α、IL-1及不良反应发生情况。
结果研究组临床有效率为94.00%，高于对照组，差异有统计学意义（χ2=6.353，P<0.05）。
治疗后，研究组VAS、BASDAI、BASFI评分分别为（2.32±0.35）分、（1.11±0.35）分、（1.29±0.40）分，均低于对照组，差异有统计学意义（t=16.827、10.279、8.528，P<0.05）。
治疗后，研究组CRP、TNF-α、IL-1均低于对照组，差异有统计学意义（t=13.441、8.072、4.140，P<0.05）。
研究组不良反应率为16.00%，与对照组比较，差异无统计意义（χ2=0.332，P>0.05）。
结论对强直性脊柱炎患者临床治疗中联用益赛普与柳氮磺吡啶的疗效可靠，患者症状改善明显，炎性反应减轻显著，且不良反应发生率无显著增加。
［关键词］强直性脊柱炎；益赛普；柳氮磺吡啶；症状改善；炎性因子；不良反应［中图分类号］R4 ［文献标识码］A ［文章编号］1674-0742（2023）05(b)-0134-05Efficacy of Etanercept Combined with Sulfasalazine in the Treatment of Ankylosing Spondylitis and Effects on Serum IL-1 and TNF-αZHANG CaifengDepartment of Rheumatology and Immunology, Huishan District People's Hospital, Wuxi, Jiangsu Province, 214187 China[Abstract] Objective To explore the efficacy of combination therapy with Etanercept and sulfasalazine in patients with ankylosing spondylitis and its effects on serum IL-1 and TNF-α. Methods A total of 100 cases of ankylosing spondylitis admitted to Huishan District People's Hospital of Wuxi City from January 2021 to June 2022 were ran‐domly selected as the study subjects. They were randomly divided into control group treated with sulfasazine alone and study group treated with Etanercept combined with sulfasazine, with 50 cases in each group. The clinical efficacy, low back pain score (VAS), ankylosing spondylitis Activity index (BASDAI), ankylosing spondylitis function index (BASFI), CRP, TNF-α, IL-1 and the occurrence of adverse reactions were evaluated in the two groups. Results Team clinical effective rate was 94.00%, higher than that in the control group, the difference was statistically significant (χ2= 6.353, P<0.05). After treatment, VAS, BASDAI and BASFI scores of the study group were (2.32±0.35) points, (1.11±0.35) points and (1.29±0.40) points, respectively, which were lower than those of the control group, and the difference was statistically significant (t=16.827, 10.279, 8.528, P<0.05). After treatment, CRP, TNF-α and IL-1 in the study group were lower than those in the control group, the difference was statistically significant (t=13.441, 8.072, 4.140, P<0.05). The adverse reaction rate in the study group was 16.00%, compared with control group, the difference was not statistically significant (χ2=0.332, P>0.05). Conclusion In the clinical treatment of patients with ankylosing spon‐dylitis, the efficacy of Etanercept and sulfasalazine is reliable, with obvious improvement of symptoms, significant re‐[作者简介] 张彩凤（1982-），女，本科，副主任医师，研究方向为风湿免疫相关疾病。
强直性脊柱炎患者益赛普减量经验——为期1年的开放式前瞻性临床研究结果杨娉婷;赵丽娟;肖卫国【摘要】目的探索一种经济、有效、安全的强直性脊柱炎(AS)患者应用重组人肿瘤坏死因子Ⅱ型受体-抗体融合蛋白(益赛普)的减量方法.方法对入选的16例男性活动期AS患者进行1年的疗效观察.益赛普最初治疗量为25 mg每周2次皮下注射,同时开始的治疗包括沙利度胺、帕夫林及双氯芬酸钠.当疾病得到缓解(Bath强直性脊柱炎活动指数＜2.0,血沉＜15 mmH2O/1 h及C-反应蛋白＜0.8 mg/dl),即将益赛普每隔2个月减半量.如果减量使患者症状加重或C反应蛋白水平反弹至异常水平,则将益赛普重新调整至前一个剂量,并于下次复查时评估以确定益赛普的剂量.结果经过1年的随访观察后,4名患者可将益赛普减量至25 mg/3周,9名患者可减量至25 mg/2周,1名患者可减量至25 mg/周,2名患者由于疗效不满意于4个月时退出研究.结论沙利度胺、帕夫林及双氯芬酸钠联合低于推荐剂量的益赛普可以使大部分AS患者的病情维持在缓解状态.%Objective Safety and cost of anti-tumor necrosis factor-α treatment for ankylosing spondylitis (AS) are widely concerned in China.Here, we explored how to taper the dosage of etanercept.Methods Sixteen men with AS initially took 25 mg etanercept injection twice a week.Concomitant therapies included thalidomide (replaced by sulfasalazine in patients with peripheral arthritis), total glucosides of paeony (TGP) and diclofenac sodium.After the disease was well controlled [Bath ankylosing spondyltitis disease activity index＜2.0,erythrocyte sedimentation rate (ESR) ＜15 mmH2O/1h,and C-reactive protein (CRP) ＜0.8 mg/dl],etanecept dosage was gradully reduced in a2month step.The tanercept would come back to original dosage if back pain, peripheral arthritis, extrarticular manifestations were aggravated or CRP was rebounded.Results After 12-month treatment, the dosage of etanercept could be eventually tapered from 2×25 mg/week to 25 mg/3 weeks in 4 patients,to 25 mg/2 weeks in 9 patients,and to 25mg/week in 1 patient.Two patients were retreated at month 4 because of dissatisfactory efficacy.No serious side effect of the combination treatments was observed.Conclusion The combination of thalidomide/sulfasalazine,TGP and diclofenac sodium with low dosage etanercept could maintain AS disease in remission.【期刊名称】《中国医科大学学报》【年(卷),期】2011(040)001【总页数】4页(P57-59,63)【关键词】抗TNF-α拮抗剂;强直性脊柱炎;沙利度胺【作者】杨娉婷;赵丽娟;肖卫国【作者单位】中国医科大学附属第一医院风湿免疫科,沈阳,110001;中国医科大学附属第一医院风湿免疫科,沈阳,110001;中国医科大学附属第一医院风湿免疫科,沈阳,110001【正文语种】中文【中图分类】R593.23强直性脊柱炎（ankylosing spondylitis，AS）是一种主要累及脊柱和骶髂关节的的慢性炎症性疾病。
