关节腔内注射帕瑞昔布对膝骨关节炎患者血清及关节滑液细胞因子水平的影响

Effect of Intra-Articular Injection of Parecoxib on Cytokines Levels in Serum andSynovial Fluid of Patients with Knee Osteoarthritis

目的探讨关节腔内注射帕瑞昔布对膝骨关节炎患者血清及关节滑液细胞因子水平的影响。方法选取湖北六七二中西医结合骨科医院2018年1月至2020年1月收治的膝骨关节炎患者110例,按随机数字表分为对照组和观察组,各55例。对照组患者口服氨基葡萄糖和塞来昔布,观察组患者口服氨基葡萄糖联合关节腔内注射帕瑞昔布,均治疗6周。结果观察组患者疼痛、关节肿胀、僵硬的消失时间显著短于对照组(t=3.408,2.969,3.883,P<0.05);治疗4周后,观察组患者关节滑液中前列腺素E_(2)、神经生长因子,血清中白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均显著低于对照组(t=2.755,2.128,5.557,3.565,P<0.05),观察组患者血清白细胞介素10水平显著高于对照组(t=4.075,P<0.05)。两组患者治疗后不同时间的膝关节功能量表(KSS)评分均有显著差异(F=51.275,P<0.05),且观察组患者显著高于对照组(F=25.341,P<0.05),观察组与对照组KSS评分变化趋势有显著差异(F=40.054,P<0.05);治疗3周和6周后两组KSS评分均显著高于治疗前(P<0.05),且观察组患者显著高于对照组(t=2.383,3.202,P<0.05)。观察组不良反应发生率为9.09%,显著低于对照组的23.64%(χ^(2)=4.251,P<0.05)。结论关节腔内注射帕瑞昔布能快速改善膝骨关节炎患者的症状和膝关节功能,降低关节滑液致痛因子水平,调节血清炎性因子水平,且安全性良好。

Objective To investigate the effect of intra-articular injection of parecoxib on cytokines levels in serum and synovial fluid of patients with knee osteoarthritis.Methods A total of 110 patients with knee osteoarthritis admitted to the Hubei 672 Orthopaedic Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to January 2020 were selected and divided into the control group and the observation group according to the random number table method,with 55 cases in each group.The patients in the control group were given glucosamine and celecoxib orally,while the patients in the observation group were given glucosamine orally combined with intra-articular injection of parecoxib.Both groups were treated for six weeks.Results The disappearance time of pain,joint swelling and stiffness in the observation group was significantly shorter than that in the control group(t=3.408,2.969,3.883,P<0.05).After four weeks of treatment,the levels of prostaglandin E_(2)(PGE_(2)),nerve growth factor(NGF)in synovial fluid,serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the observation group were significantly lower than those in the control group(t=2.755,2.128,5.557,3.565,P<0.05),while the level of serum interleukin-10(IL-10)in the observation group was significantly higher than that in the control group(t=4.075,P<0.05).At different time after treatment,the Knee Society Score(KSS)scores in the two groups were significantly different(F=51.275,P<0.05),the KSS scores in the observation group were significantly higher than those in the control group(F=25.341,P<0.05),and the change trends of KSS scores between the observation group and the control group were significantly different(F=40.054,P<0.05).After three and six weeks of treatment,the KSS scores in the two groups were significantly higher than those before treatment(P<0.05),and the KSS scores in the observation group were significantly higher than those in the control group(t=2.383,3.202,P<0.05).The incidence of adverse reactions in the observation group was 9.09%,which was significantly lower than 23.64%in the control group(χ^(2)=4.251,P<0.05).Conclusion Intra-articular injection of parecoxib can quickly improve the symptoms and knee joint function of patients with knee osteoarthritis,reduce the levels of pain inducing cytokine in synovial fluid,regulate the levels of serum inflammatory factors,and it has good safety.