摘要
目的探讨氨基葡萄糖联合玻璃酸钠对大骨节病(KBD)患者血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平的影响。方法采用前瞻性设计,选取2017年1月至2019年1月烟台山医院南院收治的膝关节KBD患者分为对照组、观察组和置换组。对照组患者予以硫酸氨基葡萄糖治疗,观察组在对照组基础上加用关节腔内注射玻璃酸钠治疗,置换组采用人工膝关节置换术进行治疗。比较3组的临床疗效、治疗前及治疗后6周、6个月患者的视觉模拟评分(VAS)、西安大略和麦克马斯特大学骨性关节炎指数(WOMAC);采集患者血液样本,采用酶联免疫吸附测定(ELISA)法检测患者血清IL-1β、TNF-α水平,比较3组治疗前及治疗后6周、6个月患者血清IL-1β、TNF-α水平。结果对照组患者年龄为(53.76±7.33)岁;男19例,女23例。观察组患者年龄为(54.18±7.06)岁;男20例,女22例。置换组患者年龄为(55.17±6.43)岁;男17例,女13例。观察组治疗总有效率(92.86%,39/42)高于对照组(76.19%,32/42,χ^(2)=4.459,P<0.05)。治疗后6周、6个月,观察组VAS评分[(4.10±1.21)、(3.16±0.95)分]均显著低于对照组[(5.48±1.17)、(4.06±0.74)分,P均<0.05];治疗后6周,置换组VAS评分[(3.28±0.89)分]显著低于观察组(P<0.05)。治疗后6周、6个月,观察组WOMAC评分[(40.72±4.19)、(25.86±3.02)分]均显著低于对照组[(48.29±2.16)、(36.81±3.13)分,P均<0.05],置换组WOMAC评分[(29.68±4.22)、(23.57±3.86)分]显著低于观察组(P均<0.05)。治疗后6周、6个月,观察组血清IL-1β、TNF-α水平[(9.28±2.74)、(6.85±2.27),(12.66±4.54)、(10.34±3.48)pg/ml]均显著低于对照组[(12.78±2.79)、(10.36±2.63),(15.51±4.63)、(14.64±4.27)pg/ml,P均<0.05)],治疗后6周、6个月,置换组血清IL-1β、TNF-α水平[(6.12±3.55)、(5.39±2.23),(10.42±3.13)、(8.19±3.15)pg/ml]均显著低于观察组(P均<0.05)。结论氨基葡萄糖联合关节腔内注射玻璃酸钠对于膝关节KBD患者有一定的
Objective To study the effect of glucosamine combined with sodium hyaluronate on serum interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)levels in patients with Kashin-Beck disease(KBD).Methods In a prospective design,patients with KBD admitted to South Hospital of Yantaishan Hospital from January 2017 to January 2019 were selected and divided into control,observation,and replacement groups.The control group was treated with glucosamine sulfate,the observation group was treated with intra-articular injection of sodium hyaluronate on the basis of the control group,and the replacement group was treated with artificial knee arthroplasty.The clinical efficacy,visual analogue scale(VAS)and Western Ontario and McMaster University Osteoarthritis Index(WOMAC)of the three groups were compared before treatment,6 weeks and 6 months after treatment.Blood samples were collected from the patients,and the serum levels of IL-1βand TNF-αwere measured by enzyme-linked immunosorbent assay(ELISA)to compare the serum levels of IL-1βand TNF-αin the three groups before treatment,6 weeks and 6 months after treatment.Results The age of patients in the control group was(53.76±7.33)years old,including 19 males and 23 females.The age of patients in the observation group was(54.18±7.06)years old,including 20 males and 22 females.The age of the replacement group was(55.17±6.43)years old,including 17 males and 13 females.The total effective rate in observation group(92.86%,39/42)was significantly higher than that of the control group(76.19%,32/42,χ^(2)=4.459,P<0.05).At 6 weeks and 6 months after treatment,the VAS scores in the observation group[(4.10±1.21),(3.16±0.95)points]were significantly lower than those in the control group[(5.48±1.17),(4.06±0.74)points,P<0.05];at 6 weeks after treatment,the VAS score in the replacement group[(3.28±0.89)points]was significantly lower than that in the observation group(P<0.05).At 6 weeks and 6 months after treatment,the WOMAC scores in the observation group[(40.72±4.19,25.86±3.02)p
作者
孙冰
张朋
王静杰
刘万军
Sun Bing;Zhang Peng;Wang Jingjie;Liu Wanjun(Department of Orthopaedics,Yantaishan Hospital of Yantai,Yantai 264000,China;Department of Orthopaedics,East Hospital of Shanghai Sixth People's Hospital,Shanghai 201306,China)
出处
《中华地方病学杂志》
CAS
北大核心
2021年第3期230-234,共5页
Chinese Journal of Endemiology
