TNF-α与IL-17拮抗剂治疗强直性脊柱炎的疗效及对患者免疫功能的影响
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R914;R593.23

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江苏省药学会—恒瑞医院药学基金(H202036)


Efficacy of tumor necrosis factor antagonists and interleukin-17 antagonists in the treatment of ankylosing spondylitis and their effects on patients’ immune function
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    摘要:

    目的:探讨肿瘤坏死因子(TNF)拮抗剂与白细胞介素17(IL-17)拮抗剂治疗强直性脊柱炎(AS)的疗效及对患者 免疫功能的影响。方法:选取244例 AS患者为研究对象,根据治疗方案不同分为 TNF拮抗剂组(n=196)和IL-17拮抗剂 组(n=45)。TNF拮抗剂组患者给予阿达木单抗治疗;IL-17拮抗剂组患者给予司库奇尤单抗治疗,疗程均为24周。比较两 组患者治疗前、治疗4周及24周后疾病活动度和功能[AS疾病活动度(ASDAS)评分、BathAS功能指数(BASFI)评分及Bath AS疾病活动指数(BASDAI)评分]、临床症状[腰背部及夜间疼痛视觉模拟(VAS)评分及晨僵持续时间]、血清学指标[C反应 蛋白(CRP)、血沉(ESR)、白细胞计数(WBC)]、免疫功能[免疫球蛋白 G(IgG)、IgA、IgM]及不良反应发生情况。结果:治疗 后,TNF拮抗剂组患者 ASDAS评分低于IL-17拮抗剂组(P<0.05);BASFI评分高于IL-17拮抗剂组(P<0.05)。治疗4周 后,TNF拮抗剂组患者腰背部及夜间痛 VAS评分及晨僵持续时间低于IL-17拮抗剂组(P<0.05);治疗24周后,IL-17拮抗 剂组患者腰背部及夜间痛 VAS评分及晨僵持续时间短于 TNF拮抗剂组(P<0.05)。治疗4、24周后,两组患者 CRP、ESR、 WBC水平均下降(P<0.05),且 TNF拮抗剂组患者 CRP、ESR水平低于IL-17拮抗剂组(P<0.05);TNF拮抗剂组患者IgG 水平下降(P<0.05),且低于IL-17拮抗剂组(P<0.05)。两组患者不良反应发生情况比较,差异无统计学意义(P>0.05)。 结论:阿达木单抗起效较快,对患者免疫功能和生化指标改善效果较好,司库奇尤单抗更侧重于改善患者临床症状。

    Abstract:

    Objective: To compare the curative effect of tumor necrosis factor (TNF) antagonist and interleukin 17 (IL-17) in ankylosing spondylitis (AS) and their effects on patients’ immune function. Methods: A retrospective analysis was performed on the data of 244 patients with AS. According to different medication methods, patients were divided into TNF antagonist group (n=196, adalimumab) and IL-17 antagonist group (n=45, secukinumab). The disease activity and function \[AS Disease Activity Score (ASDAS), Bath AS Functional Index (BASFI) and Bath AS Disease Activity Index (BASDAI)\], clinical symptoms \[Visual Analog Scale (VAS) scores for lower back and nighttime pain and duration of morning stiffness\], serological indicators \[C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell count (WBC)\], immune function \[immunoglobulin G (IgG), IgA and IgM\], and incidence of adverse reactions before treatment, after 4 and 24 weeks of treatment were compared between the two groups. Results: After treatment, ASDAS was lower, and BASFI was higher in TNF antagonist group(P<0.05). The changes in pain degree at low back and night, and the duration of morning stiffness were more significant in TNF antagonist group after 4 weeks of treatment, while the above changes were more significant in IL-17 antagonist group after 24 weeks of treatment(P<0.05). After 4 and 24 weeks of treatment, the levels of CRP, ESR, and WBC in both groups decreased(P<0.05), and the levels of CRP and ESR in the TNF antagonist group were lower than those in the IL-17 antagonist group(P<0.05). The IgG level in the TNF antagonist group decreased (P<0.05) and was lower than that in the IL-17 antagonist group(P<0.05). There was no statistically significant difference in the occurrence of adverse reactions between the two groups(P>0.05). Conclusion: Adalimumab has short onset time and better improvement effect on immune function and biochemical indexes, while secukinumab is more beneficial to improve clinical symptoms in patients.

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郭静;宋冬云;崔璨;马锐;刘睿;韩淳淳. TNF-α与IL-17拮抗剂治疗强直性脊柱炎的疗效及对患者免疫功能的影响[J].川北医学院学报,2026,41(7):855-.

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  • 在线发布日期: 2026-07-17
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