蝮蛇抗栓酶辅助治疗类风湿性关节炎临床疗效观察

作者	单位
蔡青	第二军医大学附属长海医院风湿免疫科上海200433
孟济明	第二军医大学附属长海医院风湿免疫科上海200433
韩星海	第二军医大学附属长海医院风湿免疫科上海200433
刘彧	第二军医大学附属长海医院风湿免疫科上海200433
施冶青	第二军医大学附属长海医院风湿免疫科上海200433
戴生明	第二军医大学附属长海医院风湿免疫科上海200433

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中文摘要:

目的 :探讨蝮蛇抗栓酶治疗类风湿性关节炎的疗效及可能的作用机理。方法 :患者在常规予以非甾体抗炎药和改善病情药物外 ,辅以蝮蛇抗栓酶静脉滴注治疗 ,并与同期对蝮蛇抗栓酶皮试过敏者 ,以丹参注射液替代蝮蛇抗栓酶作为对照组 ,观察两组治疗前后相关临床及实验室指标变化。结果 :经 3周治疗两组患者关节肿胀指数、关节压痛指数、晨僵时间、患者疼痛评估 (VAS)、日常生活能力健康状况评估(HAQ)和血沉较治疗前均有明显改善 (P <0 0 5或P <0 0 1) ;总有效率治疗组高于对照组 (P <0 0 5 ) ;VAS、HAQ和纤维蛋白原治疗前后差值治疗组高于对照组 ,差异均有显著性 (P <0 0 5或P <0 0 1)。结论 :蝮蛇抗栓酶对缓解类风湿性关节炎临床症状有良好效果 ,而且毒副反应轻微 ,是值得推荐的辅助用药

英文摘要:

Objective: To explore the clinical effect of Agkistrodon antithrombogenase (AAT) in the treatment of rheumatoid arthritis (RA) and its possible mechanism. Methods: Besides the conventional non steroid anti inflammatory agents and disease modifying anti rheumatic drug, patients were treated supplementally with intravenous injection of AAT. The intracutaneous test showed allergic to AAT patients were treated with Salvia injection and taken as control group. Changes of related clinical indexes in the two groups were observed. Results: After 3 weeks treatment, condition of patients in both groups were improved clinically in joint swollen index, joint tenderness index, morning stiffness time, pain assessment (VAS) and health assessment questionnaire (HAQ) on daily life activity as well as ESR level (P<0 05 or P<0 01), with the VAS, HAQ and fibrinogen levels more significantly improved than those of control (P<0 05 or P<0 01), and the total effective rate higher in the AAT treated group than those in the control group (P<0 05). Conclusion: AAT has good effect on easing clinical symptoms of RA possibly through anti inflammation and improving the microcirculation with less toxic and adverse reaction, so is worthy of recommendation.

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