摘要
目的：观察透明质酸钠和塞来昔布治疗骨关节炎（OA）患者的近远期疗效的差异。方法：2010年1月至2011年10月采用随机对照方法将确诊的136例膝OA患者入选透明质酸钠治疗组（SH）和塞来昔布治疗组（CO）各68例，SH组应用透明质酸钠注射液关节腔内注射，2mL／周共5周：CO组给予口服塞来昔布胶囊200mg／d共5周。治疗前及治疗结束后1、6个月进行Lequesne指数评分和VAS疼痛评分，ELISA法检测关节液中uPA和MMP-3表达水平，6个月时再次进行Lequesne和VAS评分，对两组数据进行对比分析。结果：患者均获得随访，随访时间6-12个月，两组病例Lequesne和VAS评分治疗后1、6个月时均较术前有所降低（P〈0．05）；CO组6个月时Lequesne评分和VAS评分较1个月时有所增高（P〈0．05），而SH组未见明显变化（P〉0．05），关节液中uPA与MMP-3表达水平SH组较治疗前显著降低（P〈0．01），而CO组较治疗前略降低（P〈0．05）。结论：单独用药时透明质酸钠相对塞来昔布其疗效更持久，可能与关节液中蛋白降解酶的表达有关．因此透明质酸钠与塞来昔布联合用药治疗OA的疗效会更加确切。
Objective To compare the effects of sodium hyaluronate （SH） and celecoxib （CO） administration on the treatment of knee osteoarthritis （OA） and to investigate their influences on levels of uPA and MMP-3 in synovial fluid. Methods One hundred and thirty-six knee osteoarthritis （OA） patients from January 2010 to October 2011 were randomly enrolled into two groups： the SH group and the CO group. In the SH group, patients were injected with 2 mL sodium hyaluronate intra articulation once a week for 5 weeks. In the CO group, patients were given oral administration of celecoxib daily at a dosage of 200 mg for 5 weeks. Before and at 1,6 months after treatment, Lequesne＇s index and VAS-pain were detected to assess the clinical results of these two drugs. The levels of uPA and MMP-3 in synovial fluid were measured by using ELISA assay. Results All patients were followed up for 6 months to 12 months. The Lequesne＇s index and VAS-pain score were lowered at 1 and 6 moths after treatment in both the SH group and the CO group（P 〈 0.05）. In the CO group, however, higher Lequesne＇s index and VAS-pain score were obtained at 6 months compare to that obtained at 1 month after treatment （P 〈 0.05）. In contrast, no significant difference of Lequesne＇s index and VAS-pain score were shown at 6 months and at 1 month after treatment in the SH group （P 〉 0.05）. Dramatic reduction of the levels of uPA and MMP-3 in synovial fluid were observed in the SH group after treatment（P 〈 0.01 ）, while marginal changes were found in the CO group（P 〉 0.05）. Conclusion The redueced levels of uPA and MMP-3 in synovial fluid after treatment of sodium hyaluronate may contribute to its longer-lasting effect than that of celecoxib. Therefore, the combination of sodium hyaluronate with celecoxib may lead to better therapeutic effect on OA patients.
出处
《实用医学杂志》
CAS
北大核心
2014年第4期548-551,共4页
The Journal of Practical Medicine
基金
国家自然基金资助课题(编号:NO30960387
81260453)
关键词
骨关节炎
透明质酸钠
塞来昔布
关节液
疗效
Osteoarthritis
Sodium hyaluronate
Celecoxib
Synovial fluid
Clinical effects
