成国华

【摘 要】目的：觀察超短波对急性痛风性关节炎血清炎症因子、氧化应激表达的影响及临床疗效。方法：将78例急性痛风性关节炎患者按照随机数字表法分为治疗组和对照组，每组39例。对照组采用洛索洛芬钠治疗，治疗组在对照组基础上加超短波治疗。2组均以10 d为1个疗程。观察2组临床疗效，以及治疗前后视觉模拟评分法（VAS）评分、红细胞沉降率（ESR）、C反应蛋白（CRP）、疼痛缓解时间、肿胀缓解时间、3-硝基酪氨酸（3-NT）、8-羟基脱氧鸟苷酸（8-OHdG）、白细胞介素（IL）-1β、IL-8、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-9（MMP-9）变化情况。结果：治疗组完成39例，对照组脱落1例，完成38例。治疗组显效33例，有效4例，无效2例，总有效率为94.87%;对照组显效21例，有效12例，无效5例，总有效率为86.84%。2组比较，差异无统计学意义（P > 0.05）。治疗后，2组VAS评分、ESR、CRP、疼痛缓解时间、肿胀缓解时间、3-NT、8-OHdG、IL-1β、IL-8、TNF-α、MMP-9较治疗前均有改善（P < 0.05）;且治疗组改善程度优于对照组（P < 0.05）。所有患者治疗期间均未发生不良反应。结论：超短波联合洛索洛芬钠治疗急性痛风性关节炎可减轻炎症反应，改善关节疼痛肿胀程度，提高疗效，且不增加不良反应;其机制可能与调节氧化应激标志物3-NT、8-OHdG水平，炎症因子IL-1β、IL-8、TNF-α、MMP-9水平有关。

【关键词】 急性痛风性关节炎;超短波;炎症因子;氧化应激

【ABSTRACT】Objective：To observe the effect of ultrashort wave on the expression of serum inflammatory factors and oxidative stress in acute gouty arthritis.Methods：Seventy-eight patients with acute gouty arthritis were randomly divided into a treatment group and a control group，39 cases in each group.The control group was treated with loxoprofen sodium，and the treatment group was treated with ultrashort wave based on the treatment with loxoprofen sodium.Both groups were treated for 10 days as a course.The clinical efficacy，VAS，ESR，CRP，pain relief time，swelling relief time，3-NT，8-OHdG，IL-1β，IL-8，TNF-α and MMP-9 before and after treatment were observed.Results：Thirty-nine cases were completed in the treatment group，1 case fell off in the control group，and 38 cases were completed.In the treatment group，33 cases were markedly effective，4 cases were effective and 2 cases were ineffective，with a total effective rate of 94.87%;In the control group，21 cases were markedly effective，12 cases were effective and 5 cases were ineffective，with a total effective rate of 86.84%.There was no significant difference between the two groups（P > 0.05）.After treatment，VAS，ESR，CRP，pain relief time，swelling relief time，3-NT，8-OHdG，IL-1β，IL-8，TNF-α and MMP-9 were improved compared with those before treatment（P < 0.05），and the improvement degree of the treatment group was better than that of the control group（P < 0.05）.Conclusion：Ultrashort wave combined with loxoprofen sodium in the treatment of acute gouty arthritis can reduce the inflammatory reaction，improve the degree of joint pain and swelling，improve the curative effect，and doesnt increase the adverse reaction.Its mechanism may be related to the regulation of 3-NT，8-OHdG，IL-1β，IL-8，TNF-α and MMP-9.

【Keywords】 acute gouty arthritis;ultrashort wave;inflammatory factors;oxidative stress

急性痛风性关节炎（acute gouty arthritis，AGA）的常见临床表现为病变关节的撕裂样、针刺刀割样剧烈疼痛，并伴随局部红肿灼热、关节活动受限，严重者可出现关节畸形、肾脏损害等病症[1-3]。目前，我国痛风患病率为1%～3%，且逐年上升[4-5]，

欧美地区发病率为0.20%～1.70%[6]，部分太平洋地区超过6%[7]。急剧上升的患病率，使得痛风成为临床最常见的代谢性炎性关节病。体内单钠尿酸盐（MSU）过多地沉聚在关节囊、滑膜囊、软骨等组织中，从而导致关节周围软组织病损及炎症反应[8]。有研究指出，氧化应激因子3-硝基酪氨酸（3-NT）、8-羥基脱氧鸟苷酸（8-OHdG）水平升高可能促进了痛风性关节炎的发展[9-10]。多项……