依托考昔联合秋水仙碱对急性痛风性关节炎患者的疗效观察

Effect of etocoxib combined with colchicine on acute gouty arthritis

目的:探讨依托考昔联合秋水仙碱治疗急性痛风性关节炎的疗效及对患者血尿酸、肾功能和炎性因子的影响。方法:选择杭州市第三人民医院2018年1月至2019年6月收治的急性痛风性关节炎患者60例为研究对象,按照随机数字表法分为治疗组30例与对照组30例。对照组患者给予秋水仙碱治疗,治疗组在对照组基础上联合依托考昔治疗。两组疗程均为7 d。比较两组疗效、治疗前后关节肿胀和关节压痛积分、血尿酸、肾功能和炎性因子水平变化。结果:治疗组总有效率(90.00%)高于对照组(63.33%),差异有统计学意义(χ2=5.963,P<0.05)。治疗组治疗后关节肿胀积分[(0.49±0.10)分]和关节压痛积分[(0.38±0.09)分]均低于对照组[(0.87±0.15)分和(0.91±0.18)分],差异均有统计学意义(t=11.545、14.425,均P<0.05)。两组治疗后血尿酸、肌酐(Scr)和尿素氮(BUN)水平差异均无统计学意义(t=0.777、0.248、0.150,均P>0.05)。治疗组治疗后红细胞沉降率(ESR)[(15.21±3.04)mm/h]、C反应蛋白(CRP)[(7.06±1.04)mg/L]和白介素1β(IL-1β)[(4.17±0.76)pg/mL]均低于对照组[(21.98±3.64)mm/h、(10.94±1.26)mg/L和(6.28±1.08)pg/mL],差异均有统计学意义(t=7.819、13.008、8.751,均P<0.05)。结论:依托考昔联合秋水仙碱治疗急性痛风性关节炎疗效明显,且可减轻炎性反应。对患者血尿酸和肾功能无明显影响。

Objective:To investigate the effect of etocoxib combined with colchicine on acute gouty arthritis and its influence on serum uric acid,renal function and inflammatory factors.Methods:From January 2018 to June 2019,60 patients with acute gouty arthritis in the Third People's Hospital of Hangzhou were divided into treatment group(30 cases)and control group(30 cases)according to the random number table method.The patients in the control group were treated with colchicine,while the patients in the treatment group were treated with etocoxib on the basis of the control group.The course of treatment in both two groups was 7 days.The changes of joint swelling,joint tenderness score,blood uric acid,renal function and inflammatory factors were compared before and after treatment.Results:The total effective rate of the treatment group(90.00%)was higher than that of the control group(63.33%)(χ2=5.963,P<0.05).The scores of joint swelling[(0.49±0.10)points]and joint tenderness[(0.38±0.09)points]in the treatment group were lower than those in the control group[(0.87±0.15)points and(0.91±0.18)points](t=11.545,14.425,all P<0.05).There was no statistically significant difference in serum uric acid level between the two groups(t=0.777,P>0.05).There were no statistically significant differences in SCR and BUN between the two groups(t=0.248,0.150,all P>0.05).The ESR[(15.21±3.04)mm/h],CRP[(7.06±1.04)mg/L]and IL-1β[(4.17±0.76)pg/mL]in the treatment group were lower than those in the control group[(21.98±3.64)mm/h,(10.94±1.26)mg/L and(6.28±1.08)pg/mL](t=7.819,13.008 and 8.751,all P<0.05).Conclusion:The therapeutic effect of etocoxib combined with colchicine on acute gouty arthritis is obvious,but it has no significant effect on the blood uric acid and renal function,and it can reduce the inflammatory reaction.