| 安丽欣,张倩,李昆,等.基于微 RNA-22-3p探讨双醋瑞因联合依托考昔治疗痛风性关节炎的作用机制[J].安徽医药,2023,27(6):1162-1166. |
| 基于微 RNA-22-3p探讨双醋瑞因联合依托考昔治疗痛风性关节炎的作用机制 |
| Exploring the mechanism of diacerein combined with etoricoxib in the treatment of gouty arthritis based on microRNA-22-3p |
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| DOI：10.3969/j.issn.1009-6469.2023.06.023 |
| 中文关键词: 关节炎，痛风性 双醋瑞因 依托考昔 微 RNA-22-3p |
| 英文关键词: Arthritis, gouty Diacerein Etoricoxib miR-22-3p |
| 基金项目:秦皇岛市市级自筹项目( 202101A087) |
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| 中文摘要: |
| 目的基于微 RNA(miR)-22-3p探讨双醋瑞因联合依托考昔治疗痛风性关节炎的作用机制，为临床应用提供依据。方法选择秦皇岛市第一医院 2021年 3—9月收治的 80例病人并依照随机信封法分为观察组和对照组；对照组给予依托考昔治疗，在对照组基础上观察组给予双醋瑞因治疗，同期选择 50例高尿酸血症病人作为高尿酸组；参照《中药新药临床指导原则》中标准对病人治疗临床疗效进行判断，治疗前及治疗后对病人关节疼痛、症状体征积分进行调查；治疗前及治疗后检测受试者 C反应蛋白( CRP)、血沉、肌酐、尿酸、肿瘤坏死因子 -α(TNF-α)、白细胞介素( IL)-1、IL-6、IL-8水平；检测外周血中单个核细胞( PBMCs)中 miR-22-3p表达情况；采用 Spearman相关性检验分析 miR-22-3p探讨双醋瑞因联合依托考昔治疗痛风性关节炎疗效相关性，采用线性回归模型分析 miR-22-3p与尿酸水平关系。结果观察组总有效率 97.50%高于对照组 90.00%(P<0.05)；治疗后观察组病人数字等级量表( NRS-11)及症状体征积分均明显低于对照组( 5.33±0.91)分比( 3.12±0.87)分；(4.83±0.77)分比(3.81±0.84)分，(P<0.05)；治疗后观察组病人 CRP、血沉、肌酐、尿酸均明显低于对照组( 14.85±1.22)mg/L比( 10.42±1.02)mg/L，(18.43±1.84)mm/h比( 14.85±1.12)mm/h，(84.35±1.93)μmol/L比( 81.20±1.84)μmol/L，(408.29±13.24)μmol/L比(350.11±10.21)μmol/L，(P<0.05)；治疗后观察组病人 IL-1、IL-6、IL-18、TNF-α均明显低于对照组( 37.85±3.77)ng/L比( 31.29±3.84)ng/L，(57.63±6.11)ng/L比( 41.21±3.45)ng/L，(143.29±9.92)ng/L比( 103.23±8.54)ng/L，(72.39±2.84)ng/L比( 61.29±2.17)ng/ L，(P<0.05)；治疗后观察组病人 miR-22-3p水平明显高于对照组 1.13±0.11比 0.84±0.12，(P<0.05)；治疗后观察组病人血中 miR-22-3p与尿酸水平呈显著负相关关系，其相关性模型为 Y=?119.58X+488.87，R2=0.9143；痛风性关节炎病人血中 miR-22-3p与双醋瑞因联合依托考昔治疗临床疗效呈显著性负相关关系( r=?0.64，P<0.05)。结论采用双醋瑞因联合依托考昔治疗痛风性关节炎后可有效调控体内 miR-22-3p水平，改善病人治疗临床疗效。 |
| 英文摘要: |
| Objective To explore the mechanism of diacerein combined with etoricoxib in the treatment of gouty arthritis based on microRNA (miR)-22-3p and to provide a basis for clinical application.Methods A total of 80 patients admitted to Qinhuangdao FirstHospital from March to September 2021 were selected and divided into an observation group and a control group according to the randomized envelope method. The control group was treated with etoricoxib, and the observation group was treated with diacerein on thebasis of the control group. During the same period, 50 patients with hyperuricemia were selected as the hyperuric acid group. The clinical efficacy of patient treatment was judged with reference to the criteria in the Clinical Guidelines for New Chinese Medicines, and patients′ joint pain and symptom-sign scores were investigated before and after treatment. The levels of C-reactive protein (CRP), sedimentation rate (ESR), creatinine (SCr), uric acid (UA), tumor necrosis factor-α (TNF-α), interleukin(IL)-1, IL-6 and IL-8 were measured in the subjects before and after treatment. The expression of miR-22-3p in peripheral blood mononuclear cells (PBMCs) was detected. Spearman correlation analysis of miR-22-3p was used to explore the correlation between the efficacy of diacerein combined with etoricoxib in the treatment of gouty arthritis, and a linear regression model was used to analyze the relationship between miR-22-3p and uric acid levels.Results The total effective rate of the observation group was 97.50% higher than that of the control group (90.00%) (P< 0.05). After treatment, the numerical rating scale (NRS-11) and symptom score of patients in the observation group were significantly lower than those in the control group (5.33±0.91 vs. 3.12±0.87 and 4.83±0.77 vs. 3.81±0.84, respectively) (P<0.05). After treatment,CRP, ESR, SCr, and UA were significantly lower in patients in the observation group than in the control group [(14.85±1.22) mg/L vs.(10.42±1.02) mg/L, (18.43±1.84) mm/h vs. (14.85±1.12) mm/h, (84.35±1.93) μmol/L vs. (81.20±1.84) μmol/L and (408.29±13.24) μmol/L vs. (350.11±10.21) μmol/L, respectively] (P<0.05). After treatment, IL-1, IL-6, IL-18, and TNF-α were significantly lower in patients in the observation group than in the control group [(37.85±3.77) ng/L vs. (31.29±3.84) ng/L, (57.63±6.11) ng/L vs. (41.21±3.45) ng/L, (143.29±9.92) ng/L vs. (103.23 ±8.54) ng/L and (72.39±2.84) ng/L vs. (61.29±2.17) ng/L, respectively] (P<0.05). The miR-22-3p level was significantly higher in the observation group than in the control group after treatment (1.13±0.11 vs. 0.84±0.12, P<0.05). After treatment, there was a significant negative correlation between serum miR-22-3p and UA levels in the blood of patients in the observation group, with a correlation model of Y=? 119.58X+488.87, R2=0.9143. There was a significant negative correlation between serum miR-22-3p in blood and the clinical efficacy of diacerein combined with etoricoxib treatment in patients with gouty arthritis (r=?0.64, P <0.05).Conclusion Diacerein combined with etoricoxib in the treatment of gouty arthritis can effectively regulate the level of miR-223p in the body and improve the clinical efficacy of patient treatment. |
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