玻璃酸钠关节腔注射联合依托考昔对膝关节创伤性关节炎老年患者的临床观察  

Clinical Efficacy of Intra-Articular Injection of Sodium Hyaluronate Combined with Etoricoxib in the Treatment of Traumatic Knee Arthritis in Older Patients

作　　者：陈祖旺 林晶 陈雅君 黄志鹏 王斌 Chen Zuwang;Lin Jing;Chen Yajun;Huang Zhipeng;Wang Bin(Department of Orthopedics,the Fourth People’s Hospital of Haikou,Haikou 570311;Department of Joint Surgery,Hainan Provincial People’s Hospital,Haikou 570311;Department of Orthopedics,the Third People’s Hospital of Haikou,Haikou 570310)

机构地区：[1]海口市第四人民医院骨科,海口570311 [2]海南省人民医院关节外科,海口570311 [3]海口市第三人民医院骨科,海口570310

出　　处：《国际老年医学杂志》2022年第4期446-449,共4页International Journal of Geriatrics

基　　金：2019年海南省自然科学基金面上项目(819MS141)。

摘　　要：目的观察玻璃酸钠关节腔注射联合依托考昔治疗膝关节创伤性关节炎老年患者的临床疗效。方法选取2018年3月~2020年3月海口市第四人民医院膝关节创伤性关节炎老年患者94例作为研究对象,按照随机数字表法分为对照组和观察组,各47例。对照组膝关节腔内注射1 mg/ml的玻璃酸钠2.5 ml,在对照组基础上观察组给予依托考昔(60 mg/d)口服。视觉模拟评分法(VAS)评价关节疼痛强度,西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评价膝关节功能,酶联免疫吸附法检测基质金属蛋白酶(MMP)-3、MMP-9、白细胞介素(IL)-1β和肿瘤坏死因子α(TNF-α)的表达。结果治疗前两组VAS和WOMAC骨关节炎指数评分、关节腔液中MMP-3、MMP-9、IL-1β和TNF-α表达水平比较,差异均无统计学意义(P>0.05);治疗后观察组VAS和WOMAC骨关节炎指数评分均低于对照组,关节腔液中MMP-3、MMP-9、IL-1β和TNF-α表达水平均低于对照组,观察组总有效率高于对照组,差异均有统计学意义(P<0.05)。结论玻璃酸钠关节腔注射联合依托考昔可以显著抑制老年膝关节创伤性关节炎的炎症反应,降低MMP表达,临床疗效显著。Objective To observe the effect of intra-articular injection of sodium hyaluronate combined with etoposide on traumatic arthritis of knee joint in older patients.Methods A total of 94 older patients with knee traumatic arthritis in Haikou Fourth People’s hospital were selected from March 2018 to March 2020.They were randomly divided into the control group and the observation group,47 cases in each group.Both groups were given 2.5 ml sodium hyaluronate(1 mg/ml)by intra-articular injection,and the observation group was additionally given etoricoxib(60 mg/d).Visual analogue scale(VAS)was used to evaluate the intensity of joint pain.Western Ontario and MacMaster University(WOMAC)osteoarthritis index was used to evaluate knee function.Enzyme linked immunosorbent assay(ELISA)was used to determine the levels of matrix metalloproteinase(MMP)-3,MMP-9,interleukin-1β(IL-1β),and tumor necrosis factor-α(TNF-α).Results Before treatment,there were no significant differences in VAS and WOMAC scores,the levels of MMP-3,MMP-9,IL-1β,and TNF-αin synovial fluid between the two groups(P>0.05).After treatment,VAS and WOMAC scores in the observation group were significantly lower than those in the control group;the levels of MMP-3,MMP-9,IL-1β,and TNF-αin the observation group were significantly lower than those in the control group;the overall response rate in the observation group was significantly higher than that in the control group;the differences were statistically significant(P<0.05).Conclusion Intra-articular sodium hyaluronate injection combined with etoposide shows significant efficacy in the treatment of traumatic knee arthritis in older patients by inhibiting the inflammatory reaction and reducing MMP expression.

关 键 词：玻璃酸钠 依托考昔 膝关节创伤性关节炎 基质金属蛋白酶 炎症反应 

分 类 号：R684.3[医药卫生—骨科学]