微创针刀联合rHuEPO注射治疗痛风性关节炎的临床疗效及对TGF-1、NLRP3水平的影响  

Clinical efficacy of minimally invasive needle knife combined with rHuEPO injection in the treatment of gouty arthritis in the elderly and its effect on the level of TGF-β1 and NLRP3

作　　者：贺前松[1] 马萍[2] 陈瑶 胡晋婷 吴贤波 赵育刚[1] HE Qian-Song;MA Ping;CHEN Yao(Department of Orthopaedics,Bayi Orthopaedic Hospital,Chengdu Military Region,Chengdu 610031,Sichuan,China;不详)

机构地区：[1]成都军区八一骨科医院骨科,四川成都610031 [2]成都中医药大学基础医学院病原生物学与医学免疫学系 [3]成都体育学院运动医学与健康学院

出　　处：《中国老年学杂志》2019年第22期5540-5544,共5页Chinese Journal of Gerontology

基　　金：四川省中医药科学项目(2016C055)

摘　　要：目的研究微创针刀联合重组人促红细胞生成素(rHuEPO)注射治疗痛风性关节炎的临床疗效及对转化生长因子(TGF)-1、核苷酸结合寡聚化结构域样受体(NLRP)3水平的影响。方法90例痛风性关节炎患者依据随机数字表法分为观察组和对照组,每组45例,对照组采用微创针刀治疗,观察组在对照组基础上注射rHuEPO。比较两组治疗后的疗效,疼痛、贫血、膝关节功能恢复情况,NLRP3、TGF-1水平的变化,并统计分析不良反应发生情况。结果治疗后观察组总有效率(95.56%)显著高于对照组(82.22%),差异具有统计学意义(P<0.05)。治疗后滑膜厚度、关节积液深度均显著降低,红细胞(RBC)、血红蛋白(Hb)水平均显著增加,且观察组治疗后各指标水平显著优于对照组(P<0.05)。治疗后Lysholm评分显著增加,VAS显著下降,且观察组各评分显著优于对照组(P<0.05)。治疗后关节滑膜液TGF-1、NLRP3水平显著降低,且观察组各水平显著低于对照组(P<0.05)。结论微创针刀联合rHuEPO治疗痛风性关节炎疗效显著,可有效下调关节滑膜液NLRP3、TGF-1水平,降低疼痛反应,改善贫血症状,从而改善关节功能和提高临床疗效。Objective To study the effect of minimally invasive needle knife combined with rHuEPO injection in the treatment of gouty arthritis in the elderly and its effect on the level of TGF-β1 and NLRP3.Methods 90 elderly patients with gouty arthritis were treated from June 2016 to June 2018 and were divided into observation and control groups according to random digital table,45 cases per group.Patients in the control group were treated with minimally invasive needle knife,while the patients in the observation group were treated with injected with rHuEPO on the basis of the control group.The therapeutic effect,serum biochemical index,inflammatory factor level,the level of ET-1 and TGF-β1 and adverse reactions were compared between the two groups after treatment.The curative effect,pain,anemia,knee joint function recovery and the changes of NLRP3,TGF-β1 level were compared between the two groups,and the occurrence of adverse reactions was statistically analyzed.Results The total effective rate of observation group(97.50%)was significantly higher than that of control group(82.50%,P<0.05).After treatment,the thickness of synovium and the depth of joint fluid were significantly decreased,and the level of red blood cell(RBC)and hemoglobin(Hb)were significantly increased,and the indexes level of the observation group were significantly better than those of the control group after treatment(P<0.05).After treatment,the VAS score decreased significantly and the Lysholm score increased significantly,and the scores of the patients in the observation group were significantly better than those in the control group(P<0.05).The levels of NLRP3 and TGF-β1 in joint synovial fluid decreased significantly after treatment,the levels in the observation group were significantly lower than those in the control group(P<0.05).Conclusions Minimally invasive needle knife combined with rHuEPO is effective in the treatment of gouty arthritis in the elderly,which can effectively down-regulate NLRP3 and TGF-β1 level of joint synovial fluid,reduc

关 键 词：微创针刀 重组人促红细胞生成素(rHuEPO) 痛风性关节炎 转化生长因子(TGF)-1 核苷酸结合寡聚化结构域样受体(NLRP3) 

分 类 号：R684.3[医药卫生—骨科学]