柳氮磺砒啶联合醋氯芬酸肠溶片对AS患者炎症反应和免疫功能的影响

Effect of sulfasalazine combined with aceclofenac enteric coated tablets on inflammatory response and immune function in AS patients

目的:研究柳氮磺吡啶联合醋氯芬酸肠溶片治疗强直性脊柱炎(AS)的疗效及对患者血中外源性骨强化蛋白(SOST)、Dickkopf-1蛋白(DKK-1)表达的影响。方法:选取2019年2月至2021年2月于江南大学附属医院就诊的106例AS患者,分为对照组、观察组各53例。对照组采用柳氮磺吡啶治疗,观察组在对照组的基础上联合使用醋氯芬酸肠溶片治疗。对比两组疾病活动情况、功能恢复情况、胸廓活动度、脊柱活动度、疼痛情况;采用速率散射比浊法测定IgA、IgG、IgM水平,ELISA测定ESR、CRP、SOST、DKK-1水平;对比两组临床疗效及不良反应发生情况。结果:与对照组相比,观察组BASDAI评分、BASFI评分、ESR、CRP、IgA、IgG、IgM、DKK-1水平降低(P<0.05)。与对照组相比,观察组胸廓活动度、脊柱活动度、SOST升高(P<0.05)。观察组治疗总有效率高于对照组(P<0.05)。结论:AS患者采用柳氮磺吡啶、醋氯芬酸肠溶片联合治疗可缓解疼痛,改善SOST、DKK-1表达,抑制炎症反应,改善免疫功能,治疗效果显著。

Objective:To study the efficacy of sulfasalazine combined with aceclofenac enteric-coated tablets in the treatment of ankylosing spondylitis(AS)and the effect on the expressions of exogenous bone enhancing protein(SOST)and Dickkopf-1 protein(DKK-1)in the blood of patients.Methods:A total of 106 patients with AS who were treated in the Affiliated Hospital of Jiangnan University from February 2019 to February 2021 were selected and divided into control group and observation group,with 53 cases in each group.Control group was treated with sulfasalazine,and observation group was treated with aceclofenac enteric-coated tablets on the basis of control group.The disease activity,functional recovery,thoracic activity,spinal activity,and pain were compared between the two groups;IgA,IgG,and IgM levels were measured by rate scattering turbidimetric method,and ESR,CRP,SOST,DKK-1 levels were measured by ELISA.The clinical efficacy and adverse reactions between the two groups were compared.Results:Compared with control group,the BASDAI score,BASFI score,ESR,CRP,IgA,IgG,IgM,and DKK-1 levels in observation group were decreased(P<0.05).Compared with control group,thoracic activity,spine activity,and SOST in observation group were increased(P<0.05).The overall treatment efficiency was higher in the observation group than in the control group(P<0.05).Conclusion:The combined treatment of sulfasalazine and aceclofenac enteric-coated tablets in AS patients can relieve pain,improve the expression of SOST and DKK-1,inhibit inflammation,improve immune function,and have a significant therapeutic effect.