内科

目的探讨塞来昔布治疗老年膝骨性关节炎的临床效果及对血清炎症因子水平的影响。方法选取2016年9月至2017年9月我院骨科收治的老年膝骨性关节炎患者100例为研究对象，随机分为观察组和对照组，每组50例。观察组患者给予塞来昔布治疗，对照组给予双氯芬酸钠治疗，疗程4周。比较两组患者的临床治疗效果；比较两组患者治疗前后的Lysholm膝关节评分、血清炎症因子水平；比较治疗期间两组患者的不良反应发生情况。结果治疗4周后，观察组患者的治疗总有效率（94.0%）明显高于对照组（80.0%），临床疗效明显优于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的Lysholm膝关节评分比较差异无统计学意义（P＞0.05）；治疗4周后，两组患者的Lysholm膝关节评分均显著增高，观察组患者的评分显著高于对照组（P＜0.05）。治疗4周后，两组患者的血清肿瘤坏死因子-α（TNF-α）、白细胞介素1α（IL-1α）、白细胞介素1β（IL-1β）、白细胞介素6（IL-6）、白细胞介素18（IL-18）及超敏C-反应蛋白（hs-CRP）水平均显著降低，观察组患者的血清IL-1α、IL-1β、IL-18、hs-CRP水平低于对照组（P＜0.05）。治疗期间，两组患者均未出现肝功能异常，观察组患者的不良反应发生率（14.0%）显著低于对照组（32.0%），差异有统计学意义（P＜0.05）。结论塞来昔布治疗膝骨性关节炎患者临床疗效显著，可有效降低患者血清炎症因子水平，改善患者的膝关节功能，治疗安全性良好。

ObjectiveTo explore the clinical effect of celecoxib in the treatment of elderly knee osteoarthritis and its effect on levels of serum inflammatory factors. MethodsA total of 100 elderly patients with knee osteoarthritis admitted to the Department of Orthopedics in our hospital from September 2016 to September 2017 were selected as the research subjects, and were randomly divided into observation group and control group, with 50 cases in each group. Patients in the observation group were treated with celecoxib, and those in the control group were administered diclofenac sodium for four-week treatment course. The clinical efficacy, the Lysholm knee function scores, serum inflammatory factor levels, and the occurrence of adverse reactions were compared between the two groups before and after treatment. ResultsAfter 4 weeks of treatment, the total effective rate of treatment in the observation group (94.0%) was significantly higher than that in the control group (80.0%), and the clinical efficacy was significantly superior to that in the control group, with statistically significant differences (P＜0.05). Before treatment, there were no statistically significant differences in Lysholm knee scores between the two groups (P＞0.05). After 4 weeks of treatment, the Lysholm knee scores significantly increased in both groups, and the scores of the observation group were significantly higher than those of the control group (P＜0.05). After 4 weeks of treatment, the serum tumor necrosis factor-α (TNF-α), interleukin 1α (IL-1α), interleukin 1β (IL-1β), interleukin 6 (IL-6), Interleukin 18 (IL-18) and high-sensitivity C-reactive protein (hs-CRP) levels decreased significantly. The levels of serum IL-1α, IL-1β, IL-18 and hs-CRP in the observation group were lower than those in the control group (P＜0.05). During treatment, no abnormal liver function was observed in both groups. The occurrence of adverse reactions in the observation group (14.0%) were significantly lower than those in the control group (32.0%), with statistically significant differences (P＜0.05). ConclusionCelecoxib is effective in treating knee osteoarthritis. It can effectively decrease the levels of serum inflammatory factors and improve the knee function of patients, with a preferable treatment safty.