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目的:观察类风湿关节炎(rheumatoid arthritis,RA)合并糖尿病(diabetes mellitus,DM)患者使用甲氨蝶呤(methotrexate,MTX)联合羟基氯喹(hydroxychloroquine,HCQ)治疗前后糖化血红蛋白(glycosylated hemoglobin,HbA1C)水平的变化。方法:通过回顾性分析,选取联合使用MTX+HCQ或单独使用MTX治疗的RA合并DM患者,且在治疗前及开始治疗12个月内分别至少有1次HbA1C值,记录其年龄、性别、诊断、体重指数、使用糖皮质激素情况。计算用药前到用药后12个月内HbA1C最低值的变化。结果:40例使用HCQ+MTX和45例使用MTX患者符合入选标准。两组间年龄、性别、体重指数、用药前HbA1C水平相似,MTX+HCQ组糖皮质激素使用比例(40.00%)比HCQ组更多(26.67%)(P=0.25)。MTX+HCQ组治疗后HbA1C有明显下降(0.42%,P=0.00),且MTX+HCQ组HbA1C降低幅度高于MTX组(0.42%,0.12%,P=0.02)。结论:与单独使用MTX相比,RA合并DM患者联合使用HCQ+MTX可明显降低HbA1C水平。
Objective: To observe the effect of methotrexate (MTX) combined with hydroxychloroquine (HCQ) on glycosylated hemoglobin (HbA1C) in patients with rheumatoid arthritis (RA) and diabetes mellitus (DM) Horizontal changes. Methods: According to the retrospective analysis, we selected patients with RA combined DM with MTX + HCQ or MTX alone and had at least one HbA1C value within 12 months before treatment and at the beginning of treatment. Age, sex, diagnosis , Body mass index, glucocorticoid use. Calculate the change of the lowest value of HbA1C within 12 months after treatment. Results: Forty patients with HCQ + MTX and 45 patients with MTX met the inclusion criteria. The age, sex, body mass index and HbA1C levels were similar between the two groups. The use of glucocorticoid in the MTX + HCQ group (40.00%) was more frequent (26.67%) than in the HCQ group (P = 0.25). HbA1C was significantly decreased in MTX + HCQ group (0.42%, P = 0.00), and decreased in MTX + HCQ group compared with MTX group (0.42%, 0.12%, P = 0.02). CONCLUSIONS: HbA1C levels are significantly lower in patients with RA with DM combined with HCQ + MTX compared with MTX alone.