摘要
目的评价膝骨关节炎患者经抗神经生长因子抗体辅助治疗后的临床疗效。方法收集2015年6月至2017年6月期间在汉中市中心医院就诊的骨关节炎患者159例,随机分为3组,予以常规治疗,实验A组注射低浓度抗神经生长因子抗体,实验B组注射高浓度抗神经生长因子抗体,对照组注射安慰剂,均治疗6个月。于治疗前、治疗后、治疗后1月及3月评价WOMAC评分,在治疗前后观察临床症状改善情况,检测膝关节滑液中的TNF-α、IL-1β的水平。结果治疗前三组患者疼痛部分、僵硬部分、关节部分、WOMAC总评分比较,差异均无统计学意义(P>0.05)。治疗后三组患者疼痛部分、僵硬部分、关节部分、WOMAC总评分均有显著下降,实验B组下降较其余两组多,差异具有统计学意义(P<0.05)。治疗后1月、3月,疼痛部分评分实验B组与治疗后相比有显著下降(P<0.05),而实验A组和对照组无明显差异(P>0.05);僵硬、关节部分评分实验B组无明显升高(P>0.05),而实验A组和对照组有显著升高(P>0.05);WOMAC总评分三组患者都有升高,差异有统计学意义(P<0.05),实验B组的升高程度相对其余两组较小(P<0.05)。经过治疗,实验A组总有效率为86.8%,实验B组总有效率为92.5%,对照组总有效率为73.6%。实验A组和B组与对照组相比总有效率均较高,且差异有统计学意义(P<0.05),而实验A组与B组之间比较无显著差异(P>0.05)。三组患者在治疗前测得关节滑液TNF-α、IL-1β水平比较,差异均无统计学意义(P>0.05)。三组患者在治疗后关节滑液TNF-α、IL-1β水平均出现明显下降(P<0.05),治疗后TNF-α、IL-1β水平实验A组与B组和对照组相比较低,且实验B组显著低于A组,差异具有统计学意义(P<0.05)。结论抗神经生长因子抗体应用于膝骨关节炎的治疗可有效缓解疼痛症状,提高患者日常生活能力,同时可降低关节滑液中的TNF-α、IL-1β炎性因子,且较高浓度抗神经生长因子具有较好的远期疗效。
Objective To evaluate the clinical effects of antibodies against nerve growth factors for patients of knee osteo-arthritis. Methods A total of 159 KOA patients were collected from Hanzhong Central Hospital between June 2015 and June 2017. Using the random number method, these patients were divided into three groups. All the patients were treated routinely for 6 months. Experimental group A was treated with a low-concentration antibody against nerve growth factors while experimental group B was treated with a high-concentration antibody against nerve growth factors. The clinical effects were observed and the changes of WOMAC indexes and the level of related cytokines in the three groups were evaluated before and after treatment. Re-sults The WOMAC indexes（ pain, stiffness, and function） were not significantly different between the three groups before treat-ment（P〉0. 05） , but were significantly lower after treatment, especially in experimental group B （P〈0. 05）. After 1 month and 3 months of treatment,the pain indexes in experimental group B significantly decreased （P〈0. 05）, but were not significantly dif-ferent in the other two groups （P〉0. 05）. The level of stiffness and function indexes of knees in experimental group B were not significantly different （P〈0. 05）,but were significantly increased in the other two groups （P〉0. 05）. The total WOMAC index significantly increased in the three groups, especially in experimental group A and in the control group （P〈0. 05）. After treatment, the total effective rate was 86. 8％ in group A, 92. 5％ in group B and 73. 6％ in the control group. The total effective rate of group A and B was significantly higher than in the control group （P〈0. 05）,but there was no significant difference between group A and group B （P〉0. 05）. TNF-α and IL-1β levels in the synovial fluid of the three groups were not significantly different be-fore treatment （P〉0. 05）, but were significantly lower after treatment （P〈0. 05）, especially in group A and group B （P〈0. 05）. Conclusion Antibodies against nerve growth factors used in treating knee osteoarthritis？ can ？ effectively relieve pain symptoms, improve the daily life ability of patients and reduce TNF-αand IL-1βlevels in inflammatory factors of the syno-vial fluid. A higher concentration of nerve growth factora has a better long-term effect.
作者
何三军
韩亦非
HE Sanjun;HAN Yitei(Department Clinical Laboratory,Hanzhong Hospital,Hanzhong,Shaanxi,723000,Chin)
出处
《解放军预防医学杂志》
CAS
2018年第5期605-608,615,共5页
Journal of Preventive Medicine of Chinese People's Liberation Army
基金
陕西省自然基础研究计划项目(No.2015JM8427)
