非甾体类抗炎药对中轴型脊柱关节炎血清血管内皮生长因子和骨形态发生蛋白-2影响研究

发布时间：2018-12-17 02:01

【摘要】：目的探讨中轴型脊柱关节炎(ax-Sp A)患者血清血管内皮生长因子(VEGF)和骨形态发生蛋白-2(BMP-2)经非甾体类抗炎药(NSAIDs)治疗后的变化情况以及与病情活动的相关性。方法选取2014年10月至2015年9月在郑州大学第一附属医院就诊的ax-Sp A患者120例,随机分为艾瑞昔布组和塞来昔布组,每组各60例。两组均治疗3个月,应用ELISA方法测定血清VEGF和BMP-2,评价治疗前后红细胞沉降率(ESR)、C反应蛋白(CRP)、Bath强直性脊柱炎病情活动指数(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)等功能评价指标及加拿大脊柱关节研究协会评分系统(SPARCC)评分情况。结果艾瑞昔布组与塞来昔布组在ESR、BASDAI、患者总体评估、Schober试验和SPARCC评分方面治疗前后差异均具有统计学意义(P0.05),BASFI、耳壁距和腰椎侧弯度差异均无统计学意义(P0.05),两组间相比以上各项指标差异均无统计学意义(P0.05)。治疗前后血清VEGF的变化情况差异具有统计学意义[(240.89±17.68)ng/L对(187.00±11.42)ng/L,P0.05],血清BMP-2治疗前后差异无统计学意义[(231.74±104.44)对(226.80±116.26)ng/L,P0.05],两组间比较差异均无统计学意义(P0.05)。血清VEGF与ESR、CRP、BASFI、耳壁距、前指地距呈正相关(r=0.628、0.542、0.238、0.299、0.353,P0.05),与腰椎侧弯度(左右侧)、Schober试验、踝间距呈负相关(r=-0.369、-0.373、-0.359、-0.274,P0.05)。血清BMP-2与CRP呈正相关(r=0.213,P0.05),与腰椎侧弯度(右侧)呈负相关(r=-0.190,P0.05)。血清VEGF与BMP-2呈正相关(r=0.326,P0.05)。HLA-B27阳性患者血清VEGF较阴性者显著升高,差异具有统计学意义(P0.05)。结论 NSAIDs在改善症状和功能的同时,可能通过影响VEGF和BMP减轻骶髂关节炎而达到延缓影像学进展的作用,并且艾瑞昔布与塞来昔布疗效相当。血清VEGF可以作为评价ax-Sp A疾病活动、功能状态以及治疗反应的指标,这一作用与HLA-B27表达情况相关。
[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 卤17.68) ng/L vs (187.00 卤11.42) ng/L,P0.05]. There was no significant difference in serum BMP-2 before and after treatment [(231.74 卤104.44) vs (226.80 卤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.
【作者单位】：郑州大学第一附属医院
【基金】：河南省科技厅基础研究项目河南省高等学校重点科研项目计划(16A320011)
【分类号】：R593.23

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