目的 探討巴瑞替尼聯(lián)合柳氮磺吡啶治療類風濕性關(guān)節(jié)炎的臨床療效。方法 選取2021年5月-2022年12月海南醫(yī)學院第一附屬醫(yī)院收治的82例類風濕性關(guān)節(jié)炎患者，隨機法分為對照組（41例）和治療組（41例）。對照組口服柳氮磺吡啶腸溶片，3粒/次，3次/d。在對照組的基礎(chǔ)上，治療組口服巴瑞替尼片，2 mg/次，1次/d。兩組用藥90 d。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀好轉(zhuǎn)情況，類風濕因子（RF）、紅細胞沉降率（ESR）和生活質(zhì)量評分量表（SF-36）評分，及血清細胞因子高遷移率族蛋白1（HMGB1）、白細胞介素-17（IL-17）、白細胞介素-1β（IL-1β）、腫瘤壞死因子-α（TNF-α）水平。結(jié)果 治療后，治療組患者總有效率（97.56%）明顯高于對照組（82.93%，P<0.05）。治療后，治療組臨床癥狀好轉(zhuǎn)情況均顯著好于對照組（P<0.05）。治療后，兩組患者RF、ESR指標明顯低于治療前，而SF-36評分指標顯著高于治療前（P<0.05），且治療組RF、ESR和SF-36評分指標明顯好于對照組（P<0.05）。治療后，兩組患者血清細胞因子HMGB1、IL-17、IL-1β、TNF-α水平明顯低于治療前（P<0.05），且治療組均顯著低于對照組（P<0.05）。結(jié)論 巴瑞替尼聯(lián)合柳氮磺吡啶治療類風濕性關(guān)節(jié)炎效果確切，能有效降低ESR、RF和炎癥因子水平，改善患者生活質(zhì)量。

Objective To explore the clinical efficiency of baricitinib combined with sulfasalazine in treatment of rheumatoid arthritis. Methods Patients (82 cases) with rheumatoid arthritis in the First Affiliated Hospital of Hainan Medical College from May 2021 to December 2022 were randomly divided into control (41 cases) and treatment (41 cases) group. Patients in the control group were po administered with Sulfasalazine Enteric-coated Tablets, 3 grains/time, three times daily. Patients in the treatment group were po administered with Baricitinib Tablets on the basis of the control group, 2 mg/time, once daily. Patients in two groups were treated for 90 d. After treatment, the clinical evaluation was evaluated, and the improvement of symptom, RF, ESR and SF-36 scores, and the levels of serum HMGB1, IL-17, IL-1β and TNF-α in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of patients in the treatment group (97.56%) was significantly higher than that in the control group (82.93%, P < 0.05). After treatment, the clinical symptom improvement in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the indexes of RF and ESR in two groups were significantly lower than those before treatment, while SF-36 score was higher than that before treatment (P < 0.05), and RF, ESR and SF-36 scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of serum cytokines HMGB1, IL-17, IL-1β and TNF-α in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Baricitinib combined with sulfasalazine in treatment of rheumatoid arthritis is effective, which can effectively reduce the levels of ESR, rheumatoid factors and the level of inflammatory factors, and improve the quality of life of patients.

R976

海南省自然科學基金青年基金項目（820QN400）