非布司他联合依托考昔联合治疗急性痛风性关节炎的临床效果及对NALP3炎性体信号通路的影响

Clinical effects of febuxostat combined with etoricoxib in the treatment of acute gouty arthritis and its influence on NALP3 inflammasome signaling pathway

目的探究非布司他联合依托考昔联合治疗急性痛风性关节炎的临床效果及对NALP3炎性体信号通路的影响。方法选取无锡市第九人民医院2018年8月—2021年4月接诊82例的急性痛风性关节炎患者作为研究对象。以电脑随机数法将其分为联合组和对照组,对照组41例予以依托考昔给药治疗,联合组在对照组基础上联合非布司他给药,评估两组患者给药1周后的临床疗效,治疗前后血液生化指标[血尿酸(UA)、肌酐(Cr)及尿素氮(BUN)]、疼痛水平、NALP3炎性体信号通路基因表达水平,统计治疗期间药物不良反应。结果联合组治疗有效率高于对照组(P<0.05);治疗后,两组NALP3、ASC及Caspase-1表达量均低于治疗前,联合组低于对照组(P<0.05);治疗后,两组患者的UA水平均低于治疗前,且联合组低于对照组(P<0.05);治疗后,两组患者的关节疼痛评分均低于治疗前,且联合组低于对照组(P<0.05);两组患者的不良反应发生率比较差异无统计学意义(P>0.05)。结论非布司他联合依托考昔治疗急性痛风性关节炎患者,可有效降低患者血液UA水平,减轻关节疼痛程度,抑制NALP3炎性体信号通路,临床疗效较优且安全良好。

Objective To explore the clinical effects of febuxostat combined with etoricoxib in the treatment of acute gouty arthritis and its influence on the NALP3 inflammasome signaling pathway.Methods Eighty-two patients with acute gouty arthritis admitted to Wuxi Ninth People's Hospital from August 2018 to April 2021 were divided into a combined group and a control group by computer random number method,41 patients in the control group were given etocroxy administration,while the combined group was given febuxostat administration on the basis of the control group.The clinical efficacy of the two groups after 1 week of administration was evaluated.Blood biochemical indexes[serum uric acid(UA),creatinine(Cr)and urea nitrogen(BUN)],pain level,gene expression level of NALP3 inflammasome signaling pathway before and after treatment,and adverse drug reactions during treatment were counted.Results The effective rate of combined group was higher than that of control group(P<0.05).After treatment,the scores of NALP3,ASC,Caspase-1,UA and joint pain in both groups were lower than those in the control group(P<0.05).There were no serious adverse reactions in both groups.Conclusion Febuxostat combined with etoricoxib in treatment of patients with acute gouty arthritis effectively reduces the blood UA level,alleviates the joint pain,and inhibits the NALP3 inflammasome signaling pathway.And such a therapy is rather safe.