不同肿瘤坏死因子-α拮抗剂治疗强直性脊柱炎的早期疗效及对炎性指标的影响

Early treatment effects of different tumor necrosis factor-α antagonists on ankylosing spondylitis and its effect on inflammatory markers

目的探讨不同肿瘤坏死因子-α拮抗剂治疗强直性脊柱炎的疗效及对炎性指标的影响。方法选择2016年1月至2018年12月收治的160例强直性脊柱炎患者,根据区组随机法分为英夫利昔组和阿达木组,每组80例。英夫利昔组患者给予英夫利昔单抗治疗,阿达木组患者给予阿达木单抗治疗。治疗前后评估晨僵时间、腰背痛视觉模拟(VAS)评分和Bath强直性脊柱炎活动指数(BASDAI),测定血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和血沉水平。结果治疗后,2组晨僵时间、腰背痛VAS评分、BASDAI以及血清CRP、IL-6、TNF-α和血沉水平均低于治疗前(P<0.05)。阿达木组晨僵时间、腰背痛VAS评分和BASDAI低于英夫利昔组(P<0.05),而血清CRP、IL-6、TNF-α和血沉水平高于英夫利昔组(P<0.05)。结论阿达木对强直性脊柱炎患者晨僵时间、VAS评分和BASDAI的影响大于英夫利昔,而英夫利昔对强直性脊柱炎血清炎性细胞因子的影响大于阿达木。

AIM To investigate the early treatment effects of different tumor necrosis factor-a antagonists on ankylosing spondylitis and its effect on inflammatory markers. METHODS A total of 160 patients with ankylosing spondylitis were selected, and were divided into infliximab group and adamu group accorded to the block random method from January 2016 to December 2018 , with 80 patients in each group. The patients in infliximab group were given infliximab treatment,the patients in adamu group were treated with adamu. The morning stiffness time, low back pain visual analogue ( VAS) score and Bath ankylosing spondylitis activity index ( BASDAI) before and after treatment were assessed. The serum C?reactive protein ( CRP), interleukin-6 ( IL- 6 ), tumor necrosis factor-a (TNF-α) and erythrocyte sedimentation rate were measured. RESULTS After treatment, the morning stiffriess time, low back pain VAS score, BASDAI, serum CRP, IL- 6 , TNF-a and erythrocyte sedimentation rate ( ESR) in 2 groups were lower than those before treatment ( P < 0. 05 ). The morning stiffness time, low back pain VAS score and BASDAI in the adamu group were lower than those in the infliximab group ( P < 0. 05 ), and the serum CRP, IL- 6 , TNF-a and ESR in the adamu group were higher than those in the infliximab group ( P < 0. 05 ). CONCLUSION The effect of adamu on VAS score and BASDAI of ankylosing spondylitis is greater than that of infliximab. The effect of infliximab on serum inflammatory cytokines in ankylosing spondylitis is greater than that of adamu.