艾瑞昔布联合甲氨蝶呤对强直性脊柱炎患者血清VEGF、ESR、DKK-1及骨代谢的影响  

The effects of combination therapy with imrecoxib and methotrexate on serum VEGF,ESR,DKK-1 and bone metabolism in patients with ankylosing spondylitis

作　　者：蔡玉霞 王玲 郑悦玲 郭会平 CAI Yuxia;WANG Ling;ZHENG Yueling;GUO Huiping(Department of Rheumatology and Immunology,Changzhi People's Hospital,Changzhi 046000,Shanxi Province,China)

机构地区：[1]山西省长治市人民医院风湿免疫科,山西长治046000

出　　处：《世界临床药物》2024年第4期403-407,423,共6页World Clinical Drug

摘　　要：目的探讨艾瑞昔布联合甲氨蝶呤(methotrexate,MTX)对强直性脊柱炎(ankylosing spondylitis,AS)患者血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、Dickkopf-1相关蛋白(recombinant Dickkopfrelated protein 1,DKK-1)及骨代谢的影响。方法选择2020年6月至2023年6月我院风湿免疫科就诊的AS患者113例,采用随机数表法分为试验组(艾瑞昔布+MTX,n=57)和对照组(MTX,n=56)。比较两组临床疗效、血清VEGF、ESR、DKK-1、骨代谢指标[骨钙素(bone gla protein,BGP)、骨碱性磷酸酶(bone alkaline phosphatase,BALP)]及Bath AS疾病活动性指数(Bathankylosing spondylitis disease activity index,BASDAI)评分、指地距及并发症发生情况。结果治疗后,试验组总有效率高于对照组(91.23%vs 76.79%,P<0.05)。两组血清ESR、DKK-1蛋白水平较前均降低,且试验组低于对照组(P<0.05);血清VEGF水平均升高,且试验组高于对照组(P<0.05)。两组血清BGP、BALP水平较前均升高,且试验组高于对照组,C反应蛋白水平较治疗前均降低,且试验组低于对照组(P<0.05)。两组BASDAI评分、指地距水平较前均降低,且试验组低于对照组(P<0.05)。不良反应方面,两组差异无统计学意义(P>0.05)。结论艾瑞昔布联合MTX在AS的治疗中效果较好,可提高骨代谢水平,值得临床推广与运用。Objective To investigate the effects of imrecoxib combined with methotrexate(MTX)on serum vascular endothelial growth factor(VEGF),erythrocyte sedimentation rate(ESR),recombinant Dickkopf related protein 1(DKK-1),and bone metabolism in patients with ankylosing spondylitis(AS).Method A total of 113 patients with AS admitted in the rheumatology and immunology department of our hospital from June 2020 to June 2022 were selected and randomly divided into experimental group(imrecoxib+MTX,n=57)and control group(MTX,n=56)using a random number table method.The clinical efficacy,serum VEGF,ESR,DKK-1,bone metabolism indexes(bone gla protein(BGP),bone alkaline phosphatase(BALP)),and Bath AS disease activity index(BASDAI)scores,finger-ground distance,and incidence of complications between two groups were compared.Result After treatment,the total effective rate of experimental group was higher than that of control group(91.23%vs 76.79%,P<0.05).Serum ESR and DKK-1 protein levels in two groups were lower than before,and experimental group was lower than control group(P<0.05).Serum VEGF level in experimental group was higher than that in control group(P<0.05).After treatment,serum BGP and BALP levels in both groups were increased,and the levels in experimental group were higher than those in control group.And C-reactive protein(CRP)level in both groups were lower than before treatment,and the experimental group was lower than that in control group(P<0.05).BASDAI score and finger-ground distance in both groups were lower than before,and the experimental group was lower than the control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion The combination of imrecoxib and MTX is effective in the treatment of AS,can improve bone metabolism levels,and is worthy of clinical promotion and application.

关 键 词：艾瑞昔布 甲氨蝶呤 强直性脊柱炎 血管内皮生长因子 红细胞沉降率 Dickkopf-1相关蛋白 骨代谢 

分 类 号：R593.23[医药卫生—内科学]