艾瑞昔布和塞来昔布对强直性脊柱炎患者血清VEGF、BMP-2、ESR、CRP及相关功能指标的影响

Effect of Imrecoxib and Celecoxib on Serum Levels of VEGF;BMP- 2;ESR;CRP and Related Functional Parameters in Patients with Ankylosing Spondylitis

目的探讨艾瑞昔布和塞来昔布对强直性脊柱炎患者血清血管内皮生长因子（ vascular endotheli-al growth factor, vEGF）、骨形态发生蛋白-2（ bone morphogenetic protein, BMP-2）、红细胞沉降率 （ erythro-cyte sedimentation rate, ESR）、C反应蛋白（Creactive protein，CRP）及相关功能指标的影响。方法纳入2009年3月至2016年3月成都市新都区第二人民医院骨科收治的80例强直性脊柱炎患者为对象，依据治疗方案不同将其分为艾瑞昔布组（n=35）和塞来昔布组（n=45），分析血清VEGF、BMP-2、ESR、CRP与功能指标的相关性，并观察治疗前后两组血清因子（VEGF、BMP-2、ESR、CRP）、功能指标[疾病活动度（BASDAI）评分、腰部活动度（指地距离、Schober实验）]及药物安全性。结果强直性脊柱炎患者血清VEGF、BMP-2水平与CRPBASDAI评分呈明显负相关（r=-0．294、-0．287，P〈0．05），与腰部活动度呈明显正相关（r=0．304、0．317，P〈0．05），ESR、CRP与CRPBASDAI评分呈明显正相关（r=0．272、0．282，P〈0．05），但与腰部活动度呈明显负相关（r=-0．312、-0．320，P〈0．05）；治疗前两组VEGF、BMP-2、ESR、CRP、BASDAI评分、指地距离、Schober实验结果相较无显著差异（P〉0．05）；治疗后两组CRP、BASDAI评分、指地距离较治疗前明显降低，VEGF、ESR、Schober实验结果明显升高（P〈0．05），但治疗后两组VEGF、BMP-2、ESR、CRP、BASDAI评分、指地距离、Schober实验结果相较无统计学意义（P〉0．05）；治疗后两组药物不良反应发生率相较无统计学意义（P〉0．05）。结论艾瑞昔布和塞来昔布治疗强直性脊柱炎患者的临床疗效相当，两者在调节患者血清VEGF、BMP-2、ESR、CRP表达及改善患者相关功能指标等方面的积极作用类似，都有一定安全性。

Objective vascular endothelial growth sedimentation rate （ESR） , To investigate the effect of imrecoxib and celecoxib on serum levels of factor （VEGF）, bone morphogenetic protein-2 （ BMP-2）, erythrocyte C reactive protein （CRP） and related functional parameters in pa- tients with ankylosing spondylitis. Methods A total of 80 patients with ankylosing spondylitis trea- ted in our hospital from March 2009 to March 2016 were enrolled in the study. They were divided in- to the imrecoxib group （ treated with imrecoxib, n = 35 ） and the celecoxib group （ treated with celecoxib, n = 45） according to different treatment methods. The correlation between the serum lev-els of VEGF, BMP-2, ESR, CRP and functional indexes [ Bath Ankylosing Spondylitis Disease Activity Index （BASDAI） score, lumbar range of motion （distance between the finger and the ground, Schober test ）] was analyzed. The drug safety in the two groups was examined as well. Results The serum VEGF, BMP-2 levels were negatively correlated with the BASDAI score （ r = 4）. 294, 43. 287, P 〈 0. 05 ）, and positively with the lumbar range of motion （ r = 0. 304, 0. 317, P 〈 0.05 ）, and the ESR and CRP were positively correlated with BASDAI score （r = 0. 272, 0. 282, P 〈0. 05）, but negatively with the lumbar range of motion （r = 4）. 312, 43. 320, P 〈0. 05） . There were no significant differences in VEGF, BMP-2, ESR, CRP, BASDAI score, the distance between the finger and the ground and results of Schober test between the two groups before treatment （P 〉 0. 05） . After treatment, the CRP, BASDAI score and the distance between the finger and the ground in the two groups were significantly decreased, and the VEGF, ESR and results of Schober test were significantly increased （P 〈 0. 05 ） but there were no significant differ- ences between the two groups in these parameters mentioned above （ P 〉 0.05 ） . No significant difference was noted between the two groups in the incidence of adverse drug reactions after treat- ment （P 〉 0. 05） . Conclusion The clinical efficacy of imrecoxib and celecoxib is comparable in the treatment of patients with ankylosing spondylitis, both have similar effects in regulating the ex- pression of serum VEGF, BMP-2, ESR and CRP and improving related functional indexes and both have an acceptable safety profile.