【摘要】：目的探討中軸型脊柱關(guān)節(jié)炎(ax-Sp A)患者血清血管內(nèi)皮生長因子(VEGF)和骨形態(tài)發(fā)生蛋白-2(BMP-2)經(jīng)非甾體類抗炎藥(NSAIDs)治療后的變化情況以及與病情活動的相關(guān)性。方法選取2014年10月至2015年9月在鄭州大學(xué)第一附屬醫(yī)院就診的ax-Sp A患者120例,隨機(jī)分為艾瑞昔布組和塞來昔布組,每組各60例。兩組均治療3個月,應(yīng)用ELISA方法測定血清VEGF和BMP-2,評價治療前后紅細(xì)胞沉降率(ESR)、C反應(yīng)蛋白(CRP)、Bath強(qiáng)直性脊柱炎病情活動指數(shù)(BASDAI)、Bath強(qiáng)直性脊柱炎功能指數(shù)(BASFI)等功能評價指標(biāo)及加拿大脊柱關(guān)節(jié)研究協(xié)會評分系統(tǒng)(SPARCC)評分情況。結(jié)果艾瑞昔布組與塞來昔布組在ESR、BASDAI、患者總體評估、Schober試驗(yàn)和SPARCC評分方面治療前后差異均具有統(tǒng)計(jì)學(xué)意義(P0.05),BASFI、耳壁距和腰椎側(cè)彎度差異均無統(tǒng)計(jì)學(xué)意義(P0.05),兩組間相比以上各項(xiàng)指標(biāo)差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。治療前后血清VEGF的變化情況差異具有統(tǒng)計(jì)學(xué)意義[(240.89±17.68)ng/L對(187.00±11.42)ng/L,P0.05],血清BMP-2治療前后差異無統(tǒng)計(jì)學(xué)意義[(231.74±104.44)對(226.80±116.26)ng/L,P0.05],兩組間比較差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。血清VEGF與ESR、CRP、BASFI、耳壁距、前指地距呈正相關(guān)(r=0.628、0.542、0.238、0.299、0.353,P0.05),與腰椎側(cè)彎度(左右側(cè))、Schober試驗(yàn)、踝間距呈負(fù)相關(guān)(r=-0.369、-0.373、-0.359、-0.274,P0.05)。血清BMP-2與CRP呈正相關(guān)(r=0.213,P0.05),與腰椎側(cè)彎度(右側(cè))呈負(fù)相關(guān)(r=-0.190,P0.05)。血清VEGF與BMP-2呈正相關(guān)(r=0.326,P0.05)。HLA-B27陽性患者血清VEGF較陰性者顯著升高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 NSAIDs在改善癥狀和功能的同時,可能通過影響VEGF和BMP減輕骶髂關(guān)節(jié)炎而達(dá)到延緩影像學(xué)進(jìn)展的作用,并且艾瑞昔布與塞來昔布療效相當(dāng)。血清VEGF可以作為評價ax-Sp A疾病活動、功能狀態(tài)以及治療反應(yīng)的指標(biāo),這一作用與HLA-B27表達(dá)情況相關(guān)。
[Abstract]:Objective to investigate the changes of serum vascular endothelial growth factor (VEGF) and bone morphogenetic protein-2 (BMP-2) after treatment with non-steroidal anti-inflammatory drug (NSAIDs) in patients with ax-Sp A. The correlation of disease activity. Methods from October 2014 to September 2015, 120 patients with ax-Sp A were randomly divided into two groups (60 cases in each group). Both groups were treated for 3 months. Serum VEGF and BMP-2, were measured by ELISA method to evaluate erythrocyte sedimentation rate (ESR), C reactive protein (CRP), Bath ankylosing spondylitis disease activity index (BASDAI),) before and after treatment. The Bath ankylosing spondylitis function index (BASFI) and the Canadian Association for Spinal Joint Research (CSR) (SPARCC) scoring system. Results there were significant differences in the overall evaluation, Schober test and SPARCC score between the two groups in ESR,BASDAI, patients before and after treatment (P0.05), BASFI,). There was no significant difference in ear wall distance and lumbar curvature between the two groups (P0.05), and there was no significant difference in the above indexes between the two groups (P0.05). The changes of serum VEGF before and after treatment were statistically significant [(240.89 鹵17.68) ng/L vs (187.00 鹵11.42) ng/L,P0.05]. There was no significant difference in serum BMP-2 before and after treatment [(231.74 鹵104.44) vs (226.80 鹵116.26) ng/L,P0.05], but there was no significant difference between the two groups (P0.05). Serum VEGF was positively correlated with ear wall distance of ESR,CRP,BASFI, anterior finger and ground distance (r 0.628 0.542U 0.2380.299U 0.353P 0.05), and negatively correlated with lumbar lateral curvature (left and right side), Schober test, malleolus distance was negative (r = -0.369- 0.373a), P < 0.05). (P 0.05). There was a positive correlation between serum BMP-2 and CRP (r = 0.213), and a negative correlation between serum BMP-2 and lumbar curvature (r = 0.190) (P 0.05). There was a positive correlation between serum VEGF and BMP-2 (P 0.05). Serum VEGF in HLA-B27 positive patients was significantly higher than that in negative ones (P0.05). Conclusion while improving symptoms and functions, NSAIDs may delay the imaging progression by reducing sacroiliac arthritis by affecting VEGF and BMP, and the efficacy of Erexib and celecoxib is similar to that of Celecoxib. Serum VEGF may be used as an index to evaluate the disease activity, functional status and therapeutic response of ax-Sp A, which is related to the expression of HLA-B27.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院
【基金】：河南省科技廳基礎(chǔ)研究項(xiàng)目 河南省高等學(xué)校重點(diǎn)科研項(xiàng)目計(jì)劃(16A320011)
【分類號】：R593.23

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