Sheeran T P, Roobottom C A, Wanklyn P D, Winkles J, Richardson K, Emery P
Department of Rheumatology, Selly Oak Hospital, Birmingham, U.K.
Clin Exp Rheumatol. 1993 Jan-Feb;11(1):49-52.
The impact of therapeutic interventions on the disease process in patients with rheumatoid arthritis (RA) is complex. The effect on the acute phase response was studied in 25 in-patients on imposed bed rest, who were randomised to treatment with (n = 12) or without (n = 13) intra-articular steroids. C-reactive protein (CRP), ESR and IgA alpha-1 antitrypsin complex levels were measured on admission and on days 3 and 5. Levels at onset were not different between groups. At day 3 and day 5, a significant (p < 0.001) fall in CRP was seen only in the intra-articular steroid group. Other cytokine and disease parameter measures did not alter during the study period (although IL-6 and CRP correlated at onset in all 25 patients). The mean duration of the hospital stay was longer for the patients treated with bed rest only. Thus, bed rest when combined with intra-articular steroids produced a rapid systemic effect, while bed-rest alone did not have an effect on the acute phase response over this short time scale.
治疗性干预措施对类风湿关节炎（RA）患者疾病进程的影响较为复杂。对25名强制卧床休息的住院患者进行了关于其对急性期反应影响的研究，这些患者被随机分为接受关节内注射类固醇治疗组（n = 12）和未接受该治疗组（n = 13）。在入院时以及第3天和第5天测量了C反应蛋白（CRP）、红细胞沉降率（ESR）和IgAα-1抗胰蛋白酶复合物水平。两组患者发病时的水平并无差异。在第3天和第5天，仅在关节内注射类固醇治疗组中观察到CRP显著下降（p < 0.001）。在研究期间，其他细胞因子和疾病参数指标未发生改变（尽管在所有25名患者中，IL-6和CRP在发病时具有相关性）。仅接受卧床休息治疗的患者平均住院时间更长。因此，卧床休息与关节内注射类固醇联合使用时会产生快速的全身效应，而仅卧床休息在这段短时间内对急性期反应并无影响。
