关节镜清理术联合艾瑞昔布对膝骨性关节炎的 疗效及对MMP-2、MMP-13 水平的影响

Effect of arthroscopic debridement combined with Imrecoxib on levels of MMP-2 and MMP-13 for knee osteoarthritis

摘要:

目的 分析关节镜清理治疗膝骨性关节炎（KOA）术后联合艾瑞昔布的疗效及对基质金属蛋白酶2 （MMP-2）、基质金属蛋白酶13（MMP-13）水平的影响。方法 选取2014 年12 月-2016 年12 月遵义市第 一人民医院收治的65 例KOA 患者，根据术后用药不同将其分为对照组和观察组。两组均采用关节镜下有限 清理术治疗；对照组术后服用安慰剂治疗，观察组术后服用艾瑞昔布治疗。观察两组治疗前后关节功能改善 情况、生活质量评分情况、关节液中MMP-2、MMP-13、基质金属蛋白酶抑制剂１（TIMP-1）水平和血 清中一氧化氮（NO）、白细胞介素1β（IL-1β）及白细胞介素1（IL-1）水平变化情况。结果 两组治疗后 疼痛评分、日常活动评分、关节僵硬评分及综合评分均较治疗前下降，观察组治疗后疼痛评分、日常活动评分、 关节僵硬评分及综合评分均低于对照组（P <0.05）；两组治疗后关节液中MMP-2、MMP-13 及TIMP-1 水 平均较治疗前下降，观察组治疗后关节液中MMP-2、MMP-13 及TIMP-1 水平均低于对照组（P <0.05）。 两组治疗后血清NO 和IL-1 水平均较治疗前下降，而IL-1β 水平较治疗前上升（P <0.05）；观察组治疗后 血清NO 和IL-1 水平均低于对照组，而IL-1β 水平高于对照组（P <0.05）；两组治疗后生活质量评分较 治疗前改善，观察组治疗后生活质量评分优于对照组（P <0.05）。结论 关节镜清理术后联合艾瑞昔布治疗 KOA 可有效改善患者关节功能，降低患者关节液中MMP-2、MMP-13 水平，提高患者生活质量。

Abstract:

Objective To analyze the effect of arthroscopic treatment on knee osteoarthritis (KOA) and the effect of Imrecoxib on matrix metalloproteinase -2 (MMP-2) and matrix metalloproteinase -13 (MMP-13) after knee joint surgery. Methods A total of 65 cases of KOA from December 2014 to December 2016 in our hospital were divided into control group and observation group according to the postoperative medication. Two groups of patients were treated with limited debridement under arthroscopy. The control group received placebo after operation, while the observation group received postoperative treatment with Imrecoxib. The joint function improvement, quality of life score, levels of MMP-2 and MMP-13 in synovial fluid, matrix metalloproteinase inhibitor -1 (TIMP-1), nitric oxide (NO) level, interleukin 1 beta (IL-1 β) and of interleukin 1 (IL-1) were observed between the two groups before and after treatment. Results The pain score, daily activity score, joint stiffness score and comprehensive score were lower after treatment in both groups, and all scores above were significantly lower in observation group than control group (P < 0.05). Levels of synovial fluid MMP-2, MMP-13 and TIMP-1 were lower after treatment in both groups, all above were significantly lower in observation group than in control group (P < 0.05). Levels of serum NO and IL-1 were lower while IL-1β level was higher after treatment (P < 0.05). Level of serum NO and IL-1 were lower while IL-1β level was higher in observation group than the control group (P < 0.05). Score of quality of life was higher after treatment in both groups, and the score was significantly higher in the observation group than in the control group (P < 0.05). Conclusion Arthroscopic debridement combined with Imrecoxib for KOA can effectively improve joint function, reduce the levels of synovial fluid MMP-2 and MMP-13, and improve quality of life of the patients.