塞来昔布对强直性脊柱炎病人血清IL-1β、IL-2R及淋巴细胞亚群的影响

Effect of celecoxib on serum IL-1β,IL-2R and lymphocyte subsets in patients with ankylosing spondylitis

目的:探讨塞来昔布对强直性脊柱炎(AS)病人血清白细胞介素-1β(IL-1β)、白细胞介素-2受体(IL-2R)及淋巴细胞亚群的影响。方法:选取82例AS病人,采用随机数表法分为对照组与观察组,各41例。对照组采用依那西普注射液治疗,观察组在对照组基础上联合塞来昔布胶囊,2组均持续给药3个月。比较2组治疗前后的血清IL-1β、IL-2R、C反应蛋白(CRP)、红细胞沉降率(ESR)、淋巴细胞亚群(CD3+CD4+、CD3+CD8+、CD3-CD19+、CD16+CD56+占总淋巴细胞的百分比)、脊柱功能指标(BASDAI评分、BASFI评分、Schober试验距离、指地距离)及不良反应。结果:2组治疗后血清IL-1β、IL-2R、CRP、ESR均低于治疗前(P<0.01)。治疗后,观察组血清IL-1β、IL-2R、CRP、ESR均低于对照组(P<0.01)。2组治疗后CD3+CD4+、CD3-CD19+低于治疗前,CD3+CD8+与CD16+CD56+高于治疗前(P<0.01)。治疗后,观察组CD3+CD4+、CD3-CD19+低于对照组,CD3+CD8+与CD16+CD56+高于对照组(P<0.01)。2组治疗后BASDAI评分、BASFI评分、指地距离均低于治疗前,Schober试验距离高于治疗前(P<0.01);治疗后,观察组BASDAI评分、BASFI评分、指地距离低于对照组(P<0.01),Schober试验距离与对照组差异无统计学意义(P>0.05)。2组不良反应总发生率(7.32%vs 9.76%)比较差异无统计学意义(P>0.05)。结论:塞来昔布治疗AS病人可有效降低血清IL-1β、IL-2R水平并改善病人淋巴细胞亚群失衡,从而促进病人脊柱功能的恢复,且不良反应较少,因此塞来昔布联合依那西普治疗AS是安全、有效方案。

Objective:To investigate the effect of celecoxib on serum interleukin-1β(IL-1β),interleukin-2 receptor(IL-2R)and lymphocyte subsets in patients with ankylosing spondylitis(AS).Methods:Eighty-two AS patients were selected and divided into the control group and observation group randomly,with 41cases in each group.The control group was treated with etanercept injection,and the observation group was combined with celecoxib capsules on the basis of the control group.Both groups were given the continuous administration for 3 months.The serum IL-1β,IL-2R,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),lymphocyte subsets(CD3+CD4+,CD3+CD8+,CD3-CD19+,CD16+CD56+accounted percentage of total lymphocytes),spinal function indexes(BASDAI score,BASFI score,Schober test distance,finger-to-ground distance for before and after treatment)and adverse reactions were compared between the two groups.Results:The serum IL-1β,IL-2R,CRP and ESR after treatment in the two groups were lower than those before treatment(P<0.01).After treatment,the serum IL-1β,IL-2R,CRP,ESR in the observation group were lower than those in the control group(P<0.01).After treatment,CD3+CD4+cells and CD3-CD19+cells were lower than those before treatment,and CD3+CD8+cells and CD16+CD56+cells were higher than those before treatment(P<0.01).After treatment,CD3+CD4+cells and CD3-CD19+cells in observation group were lower than those in control group,and CD3+CD8+cells and CD16+CD56+cells were higher than those in control group(P<0.01).After treatment,the BASDAI score,BASFI score and finger-to-ground distance were lower than those in the two groups after treatment,and the Schober test distance was higher than those before treatment(P<0.01).After treatment,the BASDAI score,BASFI score and the finger-to-ground distance in observation group were lower than those in control group(P<0.01),and there was no significant difference in the Schober test distance between the two groups(P>0.05).There was no statistically significant difference in the total incidence of adverse reactions(7.32%vs 9.76%)between the two groups(P>0.05).Conclusions:The celecoxib in the treatment of AS patients can effectively reduce the serum IL-1βand IL-2R levels and improve the imbalance of lymphocyte subsets in patients,thereby promoting the recovery of patients′spinal function with few adverse reactions.Therefore,the treatment of celecoxib combined with etanercept in AS patients is safe and effective.