论文部分内容阅读
甲氨蝶呤(MTX)是治疗类风湿关节炎(RA)的首选药物,但20%~40%的RA患者服用MTX无效。MTX的血浆半衰期短,其浓度与疗效无相关性。MTX在红细胞、滑膜细胞等细胞内转化为多聚谷氨酸化甲氨蝶呤(MTXPGs),在细胞内的滞留时间较长,且与叶酸途径中关键酶的亲和力更强、抗炎作用也更强,因此选用红细胞内MTXPGs浓度来预测治疗效果及安全性成为目前研究的重点。综述MTXPGs与RA疗效和不良反应的相关性研究进展,并对影响MTX作用的相关因素进行分析,为临床合理用药提供参考。
Methotrexate (MTX) is the drug of choice for the treatment of rheumatoid arthritis (RA), but 20% to 40% of RA patients are ineffective in taking MTX. MTX short plasma half-life, its concentration and efficacy no correlation. MTX is converted to polyglutamyl methotrexate (MTXPGs) in cells such as erythrocytes and synovial cells, has a long residence time in the cell, and has a stronger affinity with the key enzyme in the folate pathway and also has an anti-inflammatory effect Stronger, so choose the concentration of erythrocyte MTXPGs to predict the efficacy and safety of the study has become the focus of the current study. This review summarizes the research progress of the correlation between the MTXPGs and the efficacy and adverse reactions of RA, and analyzes the related factors that influence the MTX effect, providing a reference for clinical rational drug use.