艾瑞昔布联合关节镜清理术治疗膝骨性关节炎的效果

Effect of Imrecoxib combined with arthroscopic debridement in the treatment of knee osteoarthritis

目的探讨艾瑞昔布联合关节镜清理术治疗膝骨性关节炎(KOA)的效果。方法选取2016年3月~2018年4月大连市第二人民医院收治的KOA患者102例为研究对象,按照随机数字表法分为对照组(关节镜清理术+术后安慰剂治疗,n=51)和观察组(关节镜清理术+术后艾瑞昔布治疗,n=51),疗程2个月。比较两组临床疗效,关节疼痛视觉模拟(VAS)评分,功能Lysholm评分情况、血清中白细胞介素1(IL-1)、白细胞介素-1β(IL-1β)及肿瘤坏死因子-α(TNF-α)水平,关节液中金属基质蛋白酶-2(MMP-2)、基质金属蛋白酶抑制剂1(TIMP-1)及金属基质蛋白酶-13(MMP-13)水平变化,及治疗期间的不良反应发生率。结果观察组临床总有效率高于对照组(P<0.05);治疗后两组VAS评分均低于治疗前,且观察组低于对照组(P<0.05);治疗后两组Lysholm评分均较治疗前升高,且观察组高于对照组(P<0.05);治疗后两组IL-1及TNF-α均低于治疗前,且观察组低于对照组(P<0.05);治疗后两组IL-1β均高于治疗前,且观察组高于对照组(P<0.05);治疗后两组MMP-2、TIMP-1及MMP-13均低于治疗前,且观察组低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论艾瑞昔布联合关节镜清理术治疗KOA效果确切,可减轻疼痛,改善膝关节功能,降低炎症介质的渗出及关节液中MMP-2、MMP-13水平,安全性较高。

Objective To investigate the effect of Imrecoxib combined with arthroscopic debridement in the treatment of knee osteoarthritis (KOA). Methods From March 2016 to April 2018, 102 patients with KOA admitted to Dalian Second People′s Hospital of were selected as subjects. According to the random number table method, the patients were divided into the control group (arthroscopic debridement + postoperative placebo treatment, n = 51) and the observation group (arthroscopic debridement + postoperative Imrecoxib treatment, n = 51), with a course of 2 months. The clinical curative effect, joint pain visual simwlation score (VAS) and function Lysholm scors, serum interleukin 1 (IL-1), IL-1β(IL-1β) and tumor necrosis factor -α(TNF-α) levels, joint fluid in the metal matrix protease-2 (MMP-2), matrix metalloproteinases inhibitor protease 1 (TIMP-1) and metal matrix-13 (MMP-13) level changes and the incidence of adverse reactions during treatment of the two groups were compared. Results The total effective rate in the observation group was higher than that in the control group (P < 0.05). VAS scores in both groups were lower after treatment than before treatment, and VAS scores in the observation group were lower than those in the control group (P < 0.05). Lysholm scores in both groups were increased after treatment, and the observation group was higher than the control group (P < 0.05). After treatment, IL-1 and TNF-α in both groups were lower than that before treatment, and those in the observation group were lower than those in the control group (P < 0.05). After treatment, IL-1β in both groups was higher than that before treatment, and that in the observation group was higher than that in the control group (P < 0.05). After treatment, MMP-2, TIMP-1 and MMP-13 in both groups were lower than that before treatment, while those in the observation group were lower than those in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion Imrecoxib combined with arthroscopic debridement is effective in the treatment of KOA, which can reduce pain, improve knee function, lower exudation of inflammatory mediators and the levels of MMP-2 and MMP-13 in articular fluid.