透明质酸钠对膝骨性关节炎患者血清基质金属蛋白酶-9、12和13水平的影响及疗效观察

Influence and curative effect observation of sodium hyaluronate on serum matrix metalloproteinase-9,12 and 13 levels of patients with knee osteoarthritis

目的探讨透明质酸钠对膝骨性关节炎(OA)患者血清基质金属蛋白酶(MMP)-9、12和13水平的影响及疗效观察。方法选择膝关节OA患者70例,随机分为观察组(n=35)和对照组(n=35)。两组患者均予以口服双氯芬酸钠肠溶胶囊75 mg,1次/d,连用5周。观察组加用透明质酸钠针2 m L关节腔内注射,每周1次,连用5周。对照组除不使用透明质酸钠注射液外治疗与观察组相一致。5周后观察两组血清MMP-9、12和13水平的变化情况,并对其疗效及不良反应进行比较。结果治疗5周后,两组血清MMP-9、12和13水平较前均明显下降(P<0.05或P<0.01),且观察组下降值较对照组更明显(P<0.05);观察组患者临床优良率为85.71%,明显高于对照组的62.86%(χ2=4.79,P<0.05);对照组和观察组分别出现不良反应9例和11例,症状均较轻,两组比较差异无统计学意义(χ2=0.28,P>0.05)。结论透明质酸治疗膝关节OA患者具有良好效果,作用机制与降低血清MMP-9、12和13水平密切相关。

Objective To discuss influence and curative effect observation of sodium hyaluronate on serum matrix metalloproteinase-9,12 and 13 （MMP-9, 12 and 13） levels of patients with knee osteoarthritis （OA）. Methods Selected 70 cases of patients with knee OA, and divided into observation group （n=35 cases） and control group （n=35 cases） in accordance at random. The patients in two groups were given oral 75 mg diclofenac sodium enteric capsules , once a day for 5 weeks. The patients in observation group were additionally given 2 mL sodium hyaluronate , injected into in-tra-articular, once a week, for 5 weeks. Excepted for sodium hyaluronate injection fluid, the patients in control group were given the same medical treatment as that in observation group. The changes of serum MMP-9 , 12 and 13 levels between the two groups before and after medical treatment were observed , and the clinical curative effect and untoward effect was compared as well. Results After 5 weeks’ treatment, the serum MMP-9, 12 and 13 levels of patients in two groups were declined more significantly than before with different degrees （P〈0.05 or P〈0.01）, and the declining rate of patients in observation group was much higher than that in control group （P〈0.05）. The clinical good and excellent rate with in observation group（85.71%） was much higher than that in control group （62.86%）（χ2=4.79,P〈0.05）. 9 and 11 cases of untoward effect were appeared between control group and observation group respectively with light symp-tom, and after comparing the occurrence rates of untoward effect of patients in two groups, with no statistical differ-ences （χ2=0.28,P＆gt;0.05）. Conclusion Sodium hyaluronate has favorable curative effect on patients with knee OA, whose mechanism of action has close effect on reducing serum MMP-9 ,12 and 13 levels.