阿达木单抗联合西药治疗强直性脊柱炎对机体免疫功能和骨质代谢的影响

Impact of adalimumab combined with western medicine in the treatment of ankylosing spondylitis on immune function and bone metabolism

目的观察阿达木单抗联合西药治疗强直性脊柱炎的疗效,及其对机体免疫功能和骨质代谢的影响。方法选择2019年1月至2021年6月在该院诊治的强直性脊柱炎患者76例为研究对象,按照随机数字表法将患者分为观察组和对照组,每组38例。对照组予以常规西药治疗,观察组在对照组的基础上采用阿达木单抗治疗。观察两组治疗后的疗效,以及两组治疗前后Bath强直性脊柱炎疾病活动性指数(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)、Bath强直性脊柱炎综合评价(BAS-G)评分、晨僵时间、Schober试验距离、扩胸度、免疫球蛋白(Ig)G、IgM、IgA、骨钙素N端中分子片段(N-MID)、β-胶原降解产物(β-CTX)和总Ⅰ型胶原氨基端延长肽(PⅠNP)水平的变化。结果观察组的总有效率为89.5%(34/38),明显高于对照组的68.4%(26/38),差异有统计学意义(χ^(2)=4.900,P<0.05)。观察组治疗后BASDAI、BASFI、BAS-G评分低于对照组(P<0.05);观察组治疗后晨僵时间短于对照组,Schober试验距离和扩胸度大于对照组,IgG、IgM和IgA水平低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后N-MID、β-CTX和PⅠNP水平低于对照组(P<0.05)。结论阿达木单抗联合西药治疗强直性脊柱炎的疗效显著,能够明显提高机体免疫功能和改善骨质代谢。

Objective To observe the efficacy of adalimumab combined with western medicine in the treatment of ankylosing spondylitis and its impact on the body′s immune function and bone metabolism.Methods A total of 76 patients with ankylosing spondylitis who were diagnosed and treated in this hospital from January 2019 to June 2021 were divided into an observation group and control group according to the method of random numbers,with 38 cases in each group.The control group was given routine western medicine treatment,and the observation group was given adalimumab on the basis of the control group.The efficacy in the two groups was observed after treatment,the Bath Ankylosing Spondylitis Disease Activity Index(BASDAI),Bath Ankylosing Spondylitis Functional Index(BASFI),Bath Ankylosing Spondylitis Global index(BAS-G),morning stiffness time,Schober test,chest expansion,immunoglobulin(Ig)G,IgM,IgA,osteocalcin N-terminal middle molecular fragment(N-MID),β-collagen degradation product(β-CTX)and total typeⅠcollagen N-terminal elongation peptide(PⅠNP)levels were compared between two groups before and after treatment.Results The total effective rate was 89.5%(34/38)in the observation group,which was significantly higher than 68.4%(26/38)in the control group(χ^(2)=4.900,P<0.05).After treatment,the scores of BASDAI,BASFI,BAS-G and morning stiffness time of observation group were significantly lower than that of control group(P<0.05),while the distance of Schober test and chest expansion were significantly higher than that of control group(P<0.05).IgG,IgM,IgA,N-MID,β-CTX and PⅠNP levels of observation group were significantly lower than that of control group(P<0.05)the levels of N-MID,β-CTX and PⅠNP in the observation group were significantly lower than those before treatment and in the control group(P<0.05).Conclusion Adalimumab combined with western medicine has a significant efficacy in the treatment of ankylosing spondylitis,which can significantly improve the body′s immune function and improve bone metabolism.