醋氯芬酸对骨关节炎软骨细胞增殖和基质代谢的影响

摘要

目的：探讨醋氯芬酸对骨关节炎软骨细胞增殖和基质代谢的影响。方法选择2011年9月～2013年9月于青海大学附属医院就诊的65例骨关节炎患者，根据随机分组原则分成观察组（n＝35），采用醋氯芬酸治疗；对照组（n＝30），采用布洛芬治疗。比较2组患者治疗后的疗效差异，比较观察组患者与对照组患者的人关节软骨细胞的5-溴脱氧尿嘧啶核苷（5-bromodeoxyuridine，BrdU）阳性率、蛋白多糖（proteoglycan，PG）与Ⅱ型胶原含量。结果观察组和治疗组患者治疗有效率分别为74.29％、73.33％，组间比较差异无统计学意义；观察组患者关节活动痛、关节压痛、15米行走时间、日常活动能力与对照组比较差异有统计学意义（P＜0.05）；观察组不良反应发生率显著低于对照组（P＜0.05）；2组BrdU阳性率之间的比较差异无统计学意义，观察组Ⅱ型胶原含量显著高于对照组（P＜0.05），观察组PG含量显著低于对照组（P＜0.05）。结论醋氯芬酸治疗骨关节炎疗效佳，不良反应发生率低，醋氯芬酸通过促进Ⅱ型胶原分泌和减少PG生成缓解患者的临床症状。%Objective To invesgate the influence of aceclofenac to cartilage cell proliferation and substrate metabolism in osteoarthritis.Methods Select 65 cases of patients with osteoarthritis who were treated in Department of Rheumatism and Hematology of Affiliated Hospital of Qinghai University from September 2011 to September 2013.Patients were divided into observation group(n=35)and control group(n=30).The observation group were treated with aceclofenac,while control group were treated with ibuprofen,Compare the efficacy of patients in two group.Compare human articular cartilage cells of 5-bromodeoxyuridine(BrdU)positive rate,the content of glycogen protein(PG)and collagen type Ⅱ in two groups. Results The effective rate of observation group and control group was 74.29%and 73.33% respectively.There was significant difference between the two groups. Compared with control group,the joints pain,joints tenderness,15 meters walking time,daily activity ability(P<0.05).The incidence of adverse reactions of observation group(1 1.43%)was significantly lower than that of control group(P<0.05 ).The difference of BrdU positive rate in two groups had no statistical significance. Ⅱ type collagen content of observation group was significantly higher than that of control group (P <0.05 ).PG of observation group was significantly lower than that of control group(P<0.05).Conclusion The efficacy of aceclofenac is good and the incidence of adverse reactions is low in treatment of osteoarthritis.Aceclofenac can alleviate clinical symptoms of patients by increasing collagen type Ⅱ and decreasing PG.