摘要
目的探讨注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(rh TNFR:Fc)对强直性脊柱炎(AS)继发骨质破坏及OPG/RANKL系统的影响。方法纳入门诊及住院确诊为AS病人60例,按数字表法随机均分为两组,治疗组:rh TNFR:Fc+甲氨蝶呤+柳氮磺吡啶;对照组:甲氨蝶呤+柳氮磺吡啶,疗程为24周,酶联免疫吸附法(ELISA)测定两组病人的骨钙素(OC)、C端肽(CTX)及细胞核因子κB受体活化子配基(RANKL)、骨保护素(OPG),比较两组上述指标的差异。AS病人骨盆片评分采用Bath AS放射学评分标准评估,选取治疗前与治疗24周后两个时间点,并进行安全性评估。结果治疗后两组病人OC均较治疗前表达升高,且治疗组表达要明显高于对照组(P<0.05),治疗后两组病人CTX均较治疗前表达下降(P<0.05),且治疗组表达要低于对照组(P<0.05);治疗后两组病人OPG均较治疗前表达有所提高(P<0.05),且治疗组表达要高于对照组(P<0.05),治疗后两组病人RANKL均较治疗前表达有下降(P<0.05),且治疗组表达要低于对照组(P<0.05);两组均未发现严重的不良反应。结论 rh TNFR:Fc治疗AS继发骨破坏可有效的降低骨代谢,促进骨形成,且不良反应少,疗效更佳。
Objective To discuss the effect of rh TNFR:Fc ankylosing spondylitis secondary to bone destruction and OPG/RANKL system.M ethods In our hospital outpatient and inpatient treatment,diagnosis of ankylosing spondylitis(ankylosing spondylitis,AS)60patients were randomly divided into two groups of30patients(treatment group)group a:rh TNFR:Fc+methotrexate+sulfasalazine;(control group)group II:methotrexate+sulfasalazine,treatment for24weeks,enzyme-linked immunosorbent assay(ELISA)determination of the two groups of patients with bone metabolism markers osteocalcin(OC),C-telopeptide(CTX)and receptor activator of nuclear factor-KB promoter ligand(RANKL),osteoprotegerin(OPG),and compare the two groups.AS patients with pelvic score sheet using the Bath AS Radiology score evaluation before selecting treatment and24weeks after two time points and safety assessments.Results After treatment,the expression of CTX decreased in both groups(P<0.05).The expression of CTX in treatment group was significantly higher than that in control group(P<0.05).The expression of OPG in the two groups after treatment was higher than that in the control group(P<0.05)and the expression in the treatment group was higher than that in the control group(P<0.05).The expression of RANKL in both groups was lower than that in the control group(P<0.05)and the expression of RANKL in the treatment group was lower than that in the control group(P<0.05).After24weeks,the pelvic score of the two groups was lower than that before treatment(P<0.05).There was no significant difference between the two groups(P>0.05).The adverse effects of the two groups were analyzed.The results showed that there was no significant difference between the two groups side effect.Conclusion rh TNFR:Fc treatment of ankylosing spondylitis secondary to bone destruction can effectively reduce bone metabolism and promote bone formation,which with fewer side effects and fewer adverse reactions is most effective.
作者
戴森华
DAI Senhua(Department of Li Rheumatism Lead ,Pingxiang People's Hospital ,Pingxiang, Jiangxi 337000 , China)
出处
《安徽医药》
CAS
2017年第8期1511-1514,共4页
Anhui Medical and Pharmaceutical Journal
基金
萍乡市卫生局项目(2014NS026)
