摘要
目的探讨硫酸羟氯喹复合甲氨蝶呤治疗类风湿性关节炎合并糖尿病的疗效及对患者胰岛功能、血糖指标和类风湿因子(RF)的影响。方法选取2016年5月至2017年5月收治的类风湿性关节炎合并2型糖尿病患者160例,按照随机数字表法均分为观察组和对照组,每组80例。对照组患者给予胰岛素和甲氨蝶呤治疗,观察组患者在此基础上加用硫酸羟氯喹治疗。观察2组患者HOMA-IR、HOMA-β、空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、RF水平和DAS28评分进行比较分析。结果治疗前2组患者HOMA-IR、HOMA-β比较,差异无统计学意义(P>0.05);与治疗前比较,治疗后2组患者HOMA-IR降低,且观察组降低更明显,治疗后2组患者HOMA-β升高,且观察组升高更明显,差异有统计学意义(P<0.05)。治疗前2组患者FBG、2 hPG、HbA1c比较,差异无统计学意义(P>0.05);同组治疗前后比较,2组患者FBG、2 hPG、HbA1c显著降低,观察组明显低于对照组,2组间差异有统计学意义(P<0.05)。治疗前2组患者DAS28评分和RF比较,差异无统计学意义(P>0.05);治疗后2组患者DAS28评分和RF水平低于治疗前,且观察组明显低于对照组,差异有统计学意义(P<0.05)。结论硫酸羟氯喹复合甲氨蝶呤治疗类风湿性关节炎合并糖尿病可有效改善胰岛功能,降低血糖水平和类风湿DAS28评定分数,值得临床推广使用。
Objective To investigate the effects of hydroxychloroquine sulfate combined with methotrexate on islet function and rheumatoid factor in patients with rheumatoid arthritis complicated by diabetes mellitus. Methods A total of 160 patients with rheumatoid arthritis complicated by diabetes mellitus who were admitted and treated in our hospital from May2016 to May 2017 were enrolled in the study. According to random digital table method,these patients were randomly divided into observation group（ n = 80） and control group（ n = 80）. The patients in control group were treated by insulin and methotrexate,however,the patients in observation group,on the basis of control group,were treated by hydroxychloroquine sulfate. The HOMA-IR,HOMA-β,FBG,2 hPG,HbA1 c,RF and DAS28 scores were observed and compared between the two groups. Results Before treatment,there were no significant differences in the levels of HOMA-IR and HOMA-β between two groups（ P〈0. 05）. After treatment,the levels of HOMA-IR were decreased in both groups,moreover,the decrease degree in observation group was more significant than that in control group,however,the levels of HOMA-β were increased,moreover,the increase degree in observation group was more significant than that in control group（ P〈0. 05）. Before treatment,there were no significant differences in the levels of FBG,2 hPG and HbA1 c between the two groups（ P〈0. 05）,but the levels og FBG,2 hPG and HbA1 c in both groups were significantly decreased,as compared with those before treatment,which in observation group were significantly lower than those in control group（ P〈0. 05）. Before treatment,there were no significant differences in DAS28 scores and rheumatoid factor between the two groups（ P〈0. 05）,however,after treatment,the DAS28 scores and rheumatoid factor levels in both groups were lower than those before treatment,which in observation group were significantly lower than those in control group（ P〈0. 05）. Conclusion The hydroxychloroquine sulfate combined with methotrexate in treatment of rheumatoid arthritis complicated by diabetes can effectively improve the function of pancreatic islet,reduce the levels of blood sugar and the DAS28 scores of rheumatoid arthritis,therefor,it is worthy of clinical promotion.
作者
杨波
杨正国
王霜
YANG Bo;YANG Zhengguo;WANG Shuang(Department of Nephrosis and endocrinology,No.148 Hospital of PLA,Shangdong,Zibo 255300,China)
出处
《河北医药》
CAS
2018年第19期2954-2956,2960,共4页
Hebei Medical Journal
