不同药物治疗对强直性脊柱炎患者病情改善、骨密度及椎体骨折影响的研究

Effect of different drug treatments on condition improvement,bone mineral density,and vertebral fractures in patients with ankylosing spondylitis

目的探究非甾体抗炎药(NSAIDs)、肿瘤坏死因子抑制剂(TNFi)、缓解病情抗风湿药(DMARDs)治疗对强直性脊柱炎患者病情改善、骨密度和椎体骨折的影响。方法采用序贯设计,将患者随机分成3组,NSAIDs组、TNFi组、DMARDs组,每组序贯纳入60例。每组患者分别采用对应的药物进行为期1年治疗。随访观察3组患者病情改善、骨密度和椎体骨折情况。结果 NSAIDs组、TNFi组、DMARDs组完成随访的患者分别为43例、46例、47例。与治疗前相比,治疗后3组患者C-反应蛋白、血沉和P物质均下降,腰椎及髋部骨密度均增加,椎体骨折数量均增加。结论 NSAIDs、TNFi、DMARDs对强直性脊柱炎患者病情改善、骨密度均有较好的疗效,但不能改善椎体骨折进程。

Objective To explore the effects of non-steroidal anti-inflammatory drugs(NSAIDs),tumor necrosis factor inhibitors(TNFi),and disease-relieving anti-rheumatic drugs(DMARDs)on the improvement of condition,bone mineral density,and vertebral fractures in patients with ankylosing spondylitis.Methods Sequential design was adopted to randomly divide the patients into 3 groups,NSAIDs group,TNFi group,and DMARDs group,and 60 patients were enrolled in each group sequentially.The patients in each group received corresponding drugs for one year.The disease improvement,bone mineral density,and vertebrate fractures in patients of the three groups were followed up.Results The completed follow-up patients in NSAIDs,TNFi,and DMARDs were 43,46,and 47,respectively.Compared with those before the treatment,the levels of C-reactive protein,erythrocyte sedimentation,and P substances decreased in patients of the three groups after the treatment.Bone mineral density of the lumbar and hip increased.The number of vertebral fractures increased.Conclusion NSAIDs,TNFi,DMARDs have better effects on the relieve of morbidity and bone mineral density of patients with ankylosing spondylitis,but they cannot relieve the process of vertebral fractures.