环孢素软胶囊联合美洛昔康片治疗老年类风湿关节炎的疗效及对血清可溶性细胞间黏附分子-1、血管生成素样蛋白2水平的影响

Efficacy of Ciclosporin Soft Capsule Combined with Meloxicam Tablets in the Treatment of Rheumatoid Arthritis in Elderly Patients and its Effect on Serum Soluble Intercellular Aadhesion Molecule-1 and Angiopoietin-Like Protein-2 Levels

目的:探讨环孢素软胶囊联合美洛昔康片治疗老年类风湿关节炎患者的疗效及对其血清可溶性细胞间黏附分子-1(sICAM-1)、血管生成素样蛋白2(ANGPTL2)水平的影响。方法:选取2016年5月至2019年1月广元市第一人民医院收治的老年类风湿关节炎患者156例作为研究对象,按照随机数字表法分为对照组和研究组,每组78例。对照组患者予以美洛昔康片治疗,研究组患者予以环孢素软胶囊联合美洛昔康片治疗。观察两组患者的临床疗效、不良反应发生情况,并对比两组患者治疗前、治疗6个月后的症状改善情况、血清炎症因子[白细胞介素10(IL-10)、白细胞介素17(IL-17)和肿瘤坏死因子α(TNF-α)]、sICAM-1及ANGPTL2水平的差异。结果:研究组患者治疗6个月后的关节疼痛评分较对照组明显降低,晨僵持续时间较对照组明显缩短,差异均有统计学意义(P<0.05)。研究组患者的总有效率为94.87%(74/78),较对照组的83.33%(65/78)明显更高,差异有统计学意义(P<0.05)。研究组患者治疗6个月后的血清IL-10、IL-17及TNF-α水平较对照组明显降低,血清sICAM-1、ANGPTL2水平较对照组明显降低,差异均有统计学意义(P<0.05)。研究组、对照组患者的不良反应发生率分别为8.97%(7/78)、6.41%(5/78),差异无统计学意义(P>0.05)。结论:环孢素软胶囊联合美洛昔康片可有效缓解老年风湿性关节病患者的症状,降低血清炎症因子、sICAM-1和ANGPTL2水平,进一步提高治疗效果,且安全性较高。

OBJECTIVE:To probe into the efficacy of Ciclosporin soft capsule combined with Meloxicam tablets in the treatment of rheumatoid arthritis in elderly patients and its effect on serum soluble intercellular adhesion molecule-1(sICAM-1)and angiopoietin-like protein-2(ANGPTL2)levels.METHODS:Totally 156 elderly patients with rheumatoid arthritis admitted into the First People’s Hospital of Guangyuan from May 2016 to Jan.2019 were selected and divided into control group and research group via random number table,with 78 cases in each group.The control group was treated with Meloxicam tablet,while the research group was given Ciclosporin soft capsule combined with Meloxicam tablets.The clinical efficacy and incidences of adverse drug reactions of both groups were observed,the differences in symptom improvements,serum inflammatory factors[interleukin-10(IL-10),interleukin-17(IL-17)and tumor necrosis factorα(TNF-α)],sICAM-1 and ANGPTL2 levels between two groups before treatment and 6 months after treatment were compared.RESULTS:The arthralgia score of research group at 6 months after treatment was significantly lower than that of the control group,and the duration of morning stiffness was significantly shorter than that of the control group,with statistically significant differences(P<0.05).The total effective rate of research group was 94.87%(74/78),which was significantly higher than that of the control group(83.33%,65/78),with statistically significant difference(P<0.05).The IL-10,IL-17 and TNF-αlevels of the research group at 6 months after treatment were significantly lower than those of the control group,the serum sICAM-1 and ANGPTL2 levels of research group were significantly lower than those of the control group,with statistically significant differences(P<0.05).The incidences of adverse drug reactions of research group and control group were respectively 8.97%(7/78)and 6.41%(5/78),the difference had no statistical significance(P>0.05).CONCLUSIONS:The combination of Ciclosporin soft capsule and Meloxicam tablets can significantly relieve symptoms of rheumatoid arthritis in elderly patients,reduce serum inflammatory factors,sICAM-1 and ANGPTL2 levels,further improve efficacy,with good safety.