摘要目的:探讨骨肽联合抗菌药物对布鲁菌病性骨关节炎患者疗效及血清肿瘤坏死因子α（TNF-α）、干扰素γ（IFN-γ）、白细胞介素1β（IL-1β）水平的影响。方法:采用前瞻性研究，选取2016年5月至2019年5月江山贝林医院收治的布鲁菌病性骨关节炎患者66例作为研究对象，年龄为28~70岁。采用随机数字表法分为对照组（ n = 33）和观察组（ n = 33），对照组予以单纯抗菌药物治疗，观察组在此基础上予以骨肽注射液治疗，两组均连续治疗2个月。比较两组临床疗效，治疗前及治疗2个月后视觉模拟疼痛量表（VAS）评分、日常生活活动能力Barthel指数、Fugl-Meyer运动功能评定量表（FMA）评分，VAS评分越高表示疼痛越剧烈，Barthel指数越高表示日常生活活动能力越强，FMA评分越高表示运动功能越好。同时，比较两组治疗前及治疗2个月后血清TNF-α、IFN-γ、IL-1β水平。 结果:观察组总有效率（96.97%，32/33）显著高于对照组（78.79%，26/33），差异有统计学意义（χ 2 = 5.12， P < 0.05）。治疗2个月后观察组VAS评分[（3.12 ± 0.85）分]显著低于对照组[（4.08 ± 0.97）分， P < 0.05]，Barthel指数[（64.72 ± 6.98）分]及FMA评分[（58.70 ± 5.58）分]显著高于对照组[（56.65 ± 6.72）、（51.43 ± 5.33）分， P均< 0.05]。治疗2个月后观察组血清TNF-α[（12.30 ± 2.35）ng/L]、IFN-γ[（10.87 ± 2.26）ng/L]、IL-1β水平[（324.28 ± 127.60）ng/L]显著低于对照组[（14.35 ± 3.13）、（15.76 ± 3.21）、（390.29 ± 131.37）ng/L， P均< 0.05]。 结论:骨肽联合抗菌药物可提升对布鲁菌病性骨关节炎的治疗效果，降低血清TNF-α、IFN-γ、IL-1β水平。

abstractsObjective:To investigate the effect of ossotide combined with antibiotics on efficacy and serum levels of tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ) and interleukin-1beta (IL-1β) in patients with brucellosis osteoarthritis.Methods:Using a prospective study, 66 patients with brucellosis osteoarthritis admitted to Jiangshan Beilin Hospital from May 2016 to May 2019 were selected as the study subjects, aged from 28 to 70 years old. The patients were randomly divided into the control group ( n = 33) and the observation group ( n = 33). The control group was treated with antibiotics alone, and the observation group was treated with ossotide injection on the basis of the treatment. Both groups were treated for 2 months. The clinical efficacy was compared between the two groups, the pain visual analogue scale (VAS) scores, the Barthel index of activities of daily living, and the Fugl-Meyer assessment (FMA) scores were compared between the two groups before treatment and 2 months after treatment. The higher the VAS score was, the more severe the pain was. The higher the Barthel index was, the stronger the activity of daily living was. The higher the FMA score was, the better the motor function was. At the same time, the serum levels of TNF-α, IFN-γ and IL-1β were compared between the two groups before treatment and 2 months after treatment. Results:The total effective rate of the observation group (96.97%, 32/33) was significantly higher than that of the control group (78.79%, 26/33), and the difference was statistically significant (χ 2 = 5.12, P < 0.05). After 2 months of treatment, the VAS score [(3.12 ± 0.85) points] of the observation group was significantly lower than that of the control group [(4.08 ± 0.97) points, P < 0.05], Barthel index [(64.72 ± 6.98) points] and FMA score [(58.70 ± 5.58) points] were significantly higher than those of the control group [(56.65 ± 6.72), (51.43 ± 5.33) points, P < 0.05]. After 2 months of treatment, serum levels of TNF-α [(12.30 ± 2.35) ng/L], IFN-γ [(10.87 ± 2.26) ng/L] and IL-1β [(324.28 ± 127.60) ng/L] of the observation group were significantly lower than those of the control group [(14.35 ± 3.13), (15.76 ± 3.21), (390.29 ± 131.37) ng/L, P < 0.05]. Conclusion:Ossotide combined with antibiotics can improve the therapeutic effect of brucellosis osteoarthritis and reduce the serum levels of TNF-α, IFN-γ, and IL-1β.