地塞米松棕榈酸酯联合利多卡因治疗膝骨性关节炎患者疼痛及基质金属蛋白酶3、基质金属蛋白酶抑制剂1表达的影响

Effects of Dexamethasone Palmitate Combined with Lidocaine on Pain and Expression of MMP-3 and TIMP-1 in Patients with Knee Osteoarthritis

目的:探讨地塞米松棕榈酸酯(DXP)联合利多卡因治疗膝骨性关节炎(KOA)的临床效果和对血清基质金属蛋白酶3(MMP-3)、基质金属蛋白酶抑制剂1(TIMP-1)水平的影响。方法:选取广东医科大学附属第二医院2018年8月—2020年8月收治的KOA患者88例,按随机数表法分为对照组(44例)和观察组(44例)。两组患者均常规口服氨基葡萄糖,对照组关节腔内注射DXP治疗,观察组在上述基础上加用利多卡因治疗。比较两组患者临床疗效、疼痛评分、膝关节功能、血清学指标、炎性因子水平和不良反应。结果:观察组总有效率较对照组高,差异有统计学意义(χ^(2)=8.070,P<0.05);观察组治疗后VAS评分低于对照组,差异有统计学意义(χ^(2)=4.062,P<0.05);观察组治疗后日常生活、疼痛、关节僵硬及总分低于对照组,差异有统计学意义(t=9.266、8.301、7.622、8.460,P<0.05);观察组治疗后MMP-3,低于对照组,TIMP-1高于对照组,差异有统计学意义(t=6.466、4.560,P<0.05);观察组治疗后TNF-α、IL-1β、IL-6水平低于对照组,差异有统计学意义(t=5.920、9.592、5.689,P<0.05);两组患者均无严重不良反应发生。结论:DXP联合利多卡因可增强KOA治疗效果,降低血清内MMP-3水平,加快炎症反应消退,缓解临床症状,安全可靠。

Objective:To investigate the clinical effect of dexamethasone palmitate(DXP)combined with lidocaine in the treat⁃ment of knee osteoarthritis(KOA)and its effect on serum matrix metalloproteinase 3(MMP-3)and matrix metalloproteinase inhibi⁃tor 1(TIMP-1)level.Methods:A total of 88 KOA patients admitted to the hospital from August 2018 to August 2020 were select⁃ed as the research objects,and divided into the control group and the observation group according to the random number table method,with 44 cases in each group.Both groups of patients were treated with oral glucosamine,the control group was treated with intra-articular injection of DXP,and the observation group was additionally treated with lidocaine on the above basis.The clinical efficacy,pain score,serological indicators and adverse reactions were compared between the two groups.Results:The total effec⁃tive rate of the observation group was higher than that of the control group,and the difference was statistically significant(χ^(2)=4.062,P<0.05).The VAS score of the observation group after treatment was lower than that of the control group,and the differ⁃ence was statistically significant(t=8.070,P<0.05).The daily life,pain,joint stiffness and total scores of the observation group af⁃ter treatment were lower than those of the control group,the differences were statistically significant(t=9.266,8.301,7.622,8.460,P<0.05).After treatment,the MMP-3 of the observation group was lower than of the control group,and the TIMP-1 was higher than that of the control group,the difference was statistically significant(t=6.466,4.560,P<0.05).After treatment,the levels of TNF-α,IL-1βand IL-6 in the observation group were lower than those in the control group,the difference was statistically signifi⁃cant(t=5.920,9.592,5.689,P<0.05).There were no serious adverse reactions in the two groups of patients.Conclusion:DXP combined with lidocaine can enhance the therapeutic effect of KOA,reduce the level of MMP-3 in serum,accelerate the subsid⁃ence of inflammatory response,alleviate clinical symptoms,which is safe and reliable.