分析塞来昔布与不同剂量艾瑞昔布治疗axSpA的效果及对骨代谢的影响

Effects of Celecoxib and Different Doses of Imrecoxib in the Treatment of axSpA and Their Influence on Bone Metabolism

目的:探究塞来昔布和2种剂量艾瑞昔布治疗中轴脊柱关节炎(axSpA)的效果及对患者骨代谢的影响。方法:选取我院96例axSpA患者为研究对象,采用随机数字表法分为A组、B组、C组各32例。A组给予0.2 g/d艾瑞昔布治疗,B组给予0.4 g/d艾瑞昔布治疗C组给予0.4 g/d塞来昔布治疗。比较3组治疗前及治疗12周后疾病活动性[C反应蛋白(CRP)、红细胞沉降率(ESR)、Bath强直性脊柱炎疾病活动指数(BASDAI)]、躯体活动度(踝间距、腰椎侧弯度)、功能状态[Bath强直性脊柱炎功能指数(BASFI)、加拿大脊柱骨关节研究协会评分系统(SPARCC)]、骨代谢[血清骨形成发生蛋白-2(BMP-2)、血管内皮生长因子(VEGF)、Dickkopf相关蛋白1(DKK-1)]差异,并记录3组治疗期间不良反应发生情况。结果:治疗12周后,3组疾病活动性(CRP、ESR、BASDAI)、功能状态(BASFI、SPARCC)、骨代谢(BMP-2、VEGF、DKK-1)均较治疗前降低(P<0.05),躯体活动度(踝间距及左右侧腰椎侧弯度)则较治疗前升高(P<0.05);但B组及C组组间比较,差异无统计学意义(P>0.05),而A组上述指标变化幅度低于B组及C组(P<0.05)。3组治疗期间不良反应发生情况比较,差异均无统计学意义(P>0.05)。结论:较高剂量(0.4 g/d)艾瑞昔布疗效明显优于较低剂量(0.2 g/d),不良反应也未增加,且0.4 g/d艾瑞昔布及同剂量塞来昔布治疗axSpA具有相似的疗效及安全性,适用于临床治疗。

Objective: To explore the effects of celecoxib and two doses of imrecoxib in the treatment of axial spondyloarthritis(axSpA) and their influence on bone metabolism. Methods: 96 patients with axSpA in our hospital were selected as the study subjects and were divided into group A, group B and group C according to the random number table method, with 32 cases in each group. Group A was treated with 0.2 g/d imrecoxib, and group B was given 0.4 g/d imrecoxib, and group C was given 0.4 g/d celecoxib. The disease activity[C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)],body activity(ankle spacing, lumbar vertebrae lateral curvature), functional status[Bath Ankylosing Spondylitis Functional Index(BASFI),Canadian Spinal and Bone Joint Research Association Scoring System(SPARCC)] and bone metabolism [bone morphogenetic protein-2(BMP-2), vascular endothelial growth factor(VEGF) and Dickkopf-related protein 1(DKK-1)] were compared among the three groups before treatment and after 12 w of treatment, and the occurrence of adverse reactions during treatment was recorded in the three groups.Results: After 12 w of treatment, the disease activity(CRP, ESR, BASDAI), functional status(BASFI, SPARCC) and bone metabolism(BMP-2, VEGF, DKK-1) in the three groups were lower than those before treatment(P<0.05), and the body activity(ankle spacing, left and right lateral curvature of lumbar vertebrae) was higher than that before treatment(P<0.05), However, there were no significant differences between group B and group C(P>0.05), and the changes of above indicators in group A were lower than those in group B and group C(P<0.05). There were no significant differences in adverse reactions among the three groups during treatment(P>0.05).Conclusions: The higher dose(0.4 g/d) imrecoxib has better efficacy than the lower dose(0.2 g/d), and it does not increase adverse reactions, and 0.4 g/d imrecoxib and the same dose of celecoxib have similar efficacy and safety in the treatment of axSpA, and it is suitable for clinical treatment.