依那西普对强直性脊柱炎患儿髋关节疼痛的治疗作用

Effect of the etanercept on the hip pain in children with ankylosing spondylitis

目的探讨依那西普对强直性脊柱炎（AS）患儿髋关节疼痛的早期作用。方法AS患儿77例随机分为依那西普组（A组）21例，双氯芬酸组（B组）20例，柳氮磺吡啶＋甲氨蝶呤组（C组）19例及安慰剂对照组（D组）17例。A组给予依那西普0．8mg／kg，1次／周；B组给予双氯芬酸钠肠溶片1mg／kg，2次／d；C组给予柳氮磺吡啶片15～25mg／kg，2次／d，及甲氨蝶呤片10～15mg／m^2，1次／周；D组给予维生素C0．395g，2次／d。观察不同药物治疗对AS患儿髋关节疼痛的作用。结果依那西普组及双氯芬酸组患儿用药后1d视觉模拟评分法（VAS）评分与安慰剂对照组比较差异均有统计学意义，且这种作用持续到14d以上。柳氮磺吡啶＋甲氨蝶呤组在本试验时间窗内与安慰剂对照组比较差异无统计学意义。依那西普组与双氯芬酸组患儿用药3d后VAS评分比较差异有统计学意义，该作用持续到14d以上。结论依那西普可快速持续缓解AS患儿髋关节疼痛。

Objective To study the early effect of the etanercept on the hip pain in children with ankylosing spondylitis（AS）. Methods Seventy-seven patients were randomly divided into etanercept group （group A,n = 21 cases ） , diclofenac sodium group （ group B, n = 20 eases ）, sulfasalazine plus methutrexate group （ group C, n = 19 cases ） , placebo control group （ group D ,n = 17 cases）. Group A was treated with etanercept 0.8 mg/kg,once a week. Group B was given diclofenac sodium enteric-coated tablets 1 mg/kg,2 times a day. Group C was treated with sulfasalazine tablets 15 -25 mg/kg,2 times a day and methotrexate tablets 10 -15 mg/m2 ,once a week. Group D patients were given vitamin C 0. 395 g,2 times a day,then the effect of different drugs on AS hip pain in children was observed. Results One day after administration, the visual analogue scale （VAS） score of the etanereept group and diclofenac sodium group was significantly different statistically compared with the placebo control group, and this effect continued until more than 14 days. Sulfasalazine with methotrexate group had no difference in the experimental time window compared with that of the placebo control group. The VAS score of the etanercept group compared with the dielofenac sodium was significantly different statistically,and this effect continued until more m 14 days. Conclusion Etanercept can relieve the hip pain in children with AS rapidly and continuously.