关节镜辅助抗炎药物改善膝骨关节炎预后的疗效分析  

Analysis about the curative effect of arthroscopic adjuvant anti-inflammatory drugs on the prognosis of knee osteoarthritis

作　　者：吴常杰[1] 赵新动 闫帮楷[1] 夏欢[2] 李之红 李英祥[1] WU Chang-jie;ZHAO Xin-dong;YAN Bang-kai;XIA Huan;LI Zhi-hong;LI Ying-xiang(Qitai Hospital,the Sixth Division of Xinjiang Production and Construction Corps,Changji Hui Autonomous Prefecture,831800,China;Tumor Hospital of Xinjiang Medical University,Urumqi,830011,China)

机构地区：[1]新疆生产建设兵团第六师奇台医院,昌吉回族自治州831800 [2]新疆医科大学附属肿瘤医院,乌鲁木齐830011

出　　处：《新疆医学》2021年第4期402-405,共4页Xinjiang Medical Journal

基　　金：新疆生产建设兵团第六师科技项目(项目编号:1537)。

摘　　要：目的探索抗炎治疗对于改善关节镜治疗骨关节炎的疗效分析。方法纳入2014年6月至2019年6月新疆生产建设兵团第六师奇台医院关节镜下治疗的膝关节炎患者107例,根据关节镜术后是否接受非甾体抗炎药及氨基葡萄糖治疗分为干预组和对照组。随访3个月,比较两组患者膝关节功能评分(Lysholm)、疼痛评分(Visual analogue scale,VAS)、肿瘤坏死因子(Tumor necrosis factorα,TNF-α)差异,并对差异行线性相关分析。结果术后3个月,干预组Lysholm评分显著高于对照组(t=3.178,P=0.002)。术后2个月、术后3个月,干预组VAS评分均显著低于对照组(t=-2.588,P=0.011,t=-4.216,P=0.000),且干预组TNF-α浓度均显著低于对照组(t=-4.122,P=0.000,t=-7.263,P=0.000)。干预组Lysholm评分差异与VAS评分及关节液TNF-α浓度变化呈负相关性(r=-0.810,P=0.000,r=-0.784,P=0.000),而VAS评分改变与关节液TNF-α浓度呈正相关性(r=-0.834,P=0.000)。结论关节镜治疗膝骨关节炎后积极的抗炎治疗能够有效患者患者的疼痛不适,改善膝关节功能,而该机制可能与抑制TNF-α因子水平有关。Objective To explore the curative effect of anti-inflammatory therapy on the arthroscopic treatment of osteoarthritis.Methods A total of 107 patients with knee arthritis treated by arthroscopy in Qitai Hospital of the sixth division of Xinjiang Production and Construction Corps from June 2014 to June 2019 were enrolled and divided into intervention group and control group according to receiving NSAID and glucosamine treatment after arthroscopy or not. After 3 months of follow-up, the differences of knee function score(Lysholm), visual analogue scale(VAS)and tumor necrosis factor-α (TNF-α)between two groups were compared, and the linear correlation analysis was performed for the differences. Results The Lysholm score of intervention group was significantly higher than that of control group for three months after operation,(t = 3.178, P = 0.002). At the second and third month after operation, the VAS score of the intervention group was significantly lower than that of the control group(t =-2.588, P = 0.011, t =-4.216, P = 0.000)and the TNF-αconcentration in the intervention group was significantly lower than that in the control group(t =-4.122, P = 0.000, t =-7.263, P = 0.000).The difference of Lysholm score in intervention group was negatively correlated with VAS score and TNF-α concentration in joint fluid(r =-0.810, P = 0.000, r =-0.784, P = 0.000).There was a positive correlation between the change of VAS score and the concentration of TNF-α(r =-0.834, P = 0.000). Conclusions Active anti-inflammatory treatment after arthroscopic treatment can effectively improve the pain and discomfort of patients with knee osteoarthritis, and the mechanism may be related to the inhibition of TNF-α level.

关 键 词：骨关节炎 关节镜 非甾体 氨基葡萄糖 肿瘤坏死因子Α 

分 类 号：R684.3[医药卫生—骨科学]