尼美舒利联合洛索洛芬钠对膝关节骨性关节炎患者TIMP-1 MMP-3骨代谢指标的影响

Effect of Nimesulide Combined with Loxofen Sodium on TIMP-1 MMP-3 and Bone Metabolic Indexes in Patients with Knee Osteoarthritis

目的:探讨尼美舒利联合洛索洛芬钠对膝关节骨性关节炎患者TIMP-1、MMP-3、骨代谢指标的影响。方法:本次研究纳入2019年1月至2021年9月膝关节骨性关节炎患者92例,将其作为观察对象。收集资料,依据随机-对照原则,进行分组,分为对照组(46例)和联合组(46例)。对照组予以洛索洛芬钠;联合组予以尼美舒利联合洛索洛芬钠,持续服用4周为一疗程。所有患者均完成治疗及随访,4周疗程结束后评价两组患者的疗效,治疗前后分别测定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)及骨钙素(BGP)、骨保护素(OPG)水平,记录不良反应状况。结果:对照组的总有效率为82.61%(38/46),低于观察组95.65%(44/46),差异有统计学意义(P<0.05)。与治疗前比,两组治疗4周血清MMP-3降低,血清TIMP-1升高,两组血清MMP-3、TIMP-1治疗前后差值比较,差异有统计学意义(P<0.05);与治疗前比,两组治疗4周血清BGP和OPG水平均升高;两组血清BGP和OPG水平治疗前后差值比较,差异有统计学意义(P<0.05)。两组患者不良反应率对比,差异无统计意义(P>0.05)。结论:尼美舒利联合洛索洛芬钠可以提高膝关节骨性关节炎患者的疗效,改善骨代谢及基质金属蛋白水平,安全性高。

Objective:To investigate the effects of nimesulide combined with loxofen sodium on TIMP-1,MMP-3 and bone metabolism in patients with knee osteoarthritis.Methods:From January 2019 to September 2021,92 patients with knee osteoarthritis were included in this study as the observation subjects and divided into control group(n=46)and combined group(n=46)according to the randomized-control principle.The control group was given loxofen sodium.The combined group was given nimesulide combined with loxofen sodium both group for 4 weeks as a course of treatment.All patients completed the treatment and were followed up.The efficacy of the two groups was evaluated at the end of the 4-week course of treatment.The serum levels of matrix metalloproteinase 3(MMP-3),matrix metalloproteinase inhibitor 1(TIMP-1),osteocalcin(BGP)and osteoprotegerin(OPG)were measured before and after treatment,and the adverse reactions were recorded.Results:The total effective rate of the control group was 82.61%(38/46),which was lower than that of observation group 95.65%(44/46),and the difference was statistically significant(P<0.05).Compared with before treatment,serum MMP-3 decreased and serum TIMP-1 increased in the two groups after 4 weeks of treatment,the difference of serum MMP-3 and TIMP-1 before and after treatment was statistically significant(P<0.05).Compared with before treatment,the serum BGP and OPG levels increased in both groups after 4 weeks of treatment.The difference of serum BGP and OPG levels before and after treatment between the two groups was statistically significant(P<0.05).There was no statistical significance in the adverse reaction rate between the two groups(P>0.05).Conclusion:Nimesulide combined with loxofen sodium can improve the treatment efficacy among knee osteoarthritis patients,improve bone metabolism and matrix metalloprotein level with high safety.