艾拉莫德对类风湿关节炎患者血管内皮生长因子及色素上皮衍生因子表达的影响

Effect of Ira Maude on VEGF and PEDF in patients with rheumatoid arthritis

目的:探讨艾拉莫德对类风湿关节炎(RA)患者血清及关节滑液中血管内皮生长因子(VEGF)、色素上皮衍生因子(PEDF)的影响。方法:选择本院诊治的60例RA患者,按照随机数字表法将患者分成对照组和试验组,每组30例。所有患者均采用吡罗昔康做为基础性治疗,对照组患者在此基础上加用甲氨蝶呤治疗,试验组加用艾拉莫德治疗,共90 d,比较两组患者临床症状改善、治疗效果、血清及关节滑液中VEGF、PEDF的变化。结果:两组患者治疗前DAS-28评分差异无统计学意义(P>0.05);两组治疗后的DAS-28评分较治疗前均降低,但试验组患者DAS-28评分下降更低,与对照组比较有统计学差异(P<0.05);试验组治疗总有效率为93.3%,而对照组为70%,试验组患者的治疗总有效率高于对照组(P<0.05)。治疗前,两组患者在关节压痛指数、肿胀数、晨僵时间、关节疼痛数、关节肿胀指数方面无统计学差异(P>0.05),治疗后两组患者在上述指标各维度均有所改善,但试验组的改善程度更明显,与对照组比较有统计学差异(P<0.05);两组患者治疗前血清及关节滑液中VEGF、PEDF水平无统计学差异(P>0.05);对照组治疗前后VEGF、PEDF水平无明显改变(P>0.05),试验组治疗后VEGF水平显著下降、PEDF水平显著升高,与治疗前相比,差异有统计学意义(P<0.05)。结论:艾拉莫德治疗RA患者疗效良好,其机制可能与抑制新生血管生成有关。

AIM： To evaluate the effect of Ira Maude on VEGF and PEDF in patients with rheuma- toid arthritis （RA） in serum and synovial fluid. METHODS： 60 cases of patients with RA were randomly divided into control group and experimen- tal group, with 30 cases in each group. The patients in the two groups were treated with piroxicam, pa- tients in the control group were treated with metho- trexate based on basic treatment, and patients in the test group were also treated with iguratimod for a to- tal of 90 days, in the two group with clinical symp- toms, clinical curative effect and the changes of VEGF and PEDF in serum and synovial fluid. RE- SULTS ： The score of DAS-28 between the two group had no significantly difference before treatment （P 〉 0.05 ） and were all decreased after treatment, but DAS-28 scores in the test group were lower than that in the control group （ P 〈 0.05 ） ; the total effective rate （93.3%） in test group was significantly higher than that （70%） in control group （P 〈0.05）. The terms of the indices of joint tenderness, swelling, morning stiffness time, joint pain, joint swelling in- dex were no difference before treatment （ P 〉 O. 05 ） and all improved after treatment, but improvement in the test group was better than that in the control group （P 〈 0.05 ）. The levels of VEGF and PEDF in serum and synovial fluid had no difference before treatment （P 〉 0.05 ）; There was no significant change in the control group before and after treat- ment （P 〉 O. 05 ）, but after treatment was better than that before treatment in the experimental group （ P 〈 0.05 ）. CONCLUSION ： Maude shows good clinical efficacy, and its mechanism may be related to inhibit the formation of new blood vessels.