蝮蛇抗栓酶治疗强直性脊柱炎的临床疗效评价

目的:总结应用蝮蛇抗栓酶治疗强直性脊柱炎(AS)的疗效并讨论其可能的作用机制.方法:AS患者185例,除常规应用非类固醇抗炎药和改善病情药物外,辅以蝮蛇抗栓酶0.5 U,1次/d,静脉滴注,21 d为1个疗程.同期15例AS患者,以丹参注射液16 ml替代蝮蛇抗栓酶作为对照组,其他治疗相同.常规观察比较两组治疗前后相关指标变化,并用SASS软件行统计学分析.结果:经3周治疗后,治疗组胸廓扩张度、指地距、枕墙距、下颌缘距、Schber试验结果、患者和医生对疼痛的整体评估(VAS)及患者日常生活能力问卷(HAQ)结果均有非常明显的改善(P<0.01),且优于对照组(P<0.01〉;实验室指标中红细胞沉降率(ESR)、免疫球蛋白G(IgG),血小板(Plt)及纤维蛋白(Fib)也较治疗前显著改善(P<0.01);而对照组除个别指标外均无明显改善.应用蝮蛇抗栓酶治疗,除使女性月经期出血增加、经期延长外,未发现其他不良反应.结论:蝮蛇抗栓酶治疗AS可能通过抗炎作用和改善微循环而有效地缓解临床症状,且无不良反应,值得推荐应用.

Clinical evaluation of agkistrodon halys plasmin in treatment of ankylosing spondylitis

Objective:To evaluate agkistrodon halys plasmin in treatment of ankylosing spondylitis (AS) and the mechanism.Methods:Retrospective studies were done in 185 hospitalized AS patients from 1991 to 2000 in our hospital.Besides the routine treatments of nonsteroid anti imflammatory drugs and disease modifying antirheumatic drugs,all the patients received agkistrodon halys plasmin (0.5 U) vein infusion every day for 3 weeks.Because of allegy of the plasmin,other 15 patients received salvia miltiorrhiza compound injection (16 ml) vein infusion instead.Routine tests were done before and after treatment.The statistical analysis were performed using the Statistical Package for the Social Sciences (SPSS).Results: After 3 weeks treatments, the magnitude improvement of thoracic expansion, finger ground distance, occiput wall distance,jaw sterntum distance,Schber test, pateint pain visual analogy scale(VAS),patient health assessment questionnaire (HAQ) about the activities of daily life and ESR, fibrinogen were all improved in the treatment group compared with control group( P <0.01). Except prolongation of the menstruation period, no other great side effects were found.Conclusion:Agkistrodon halys plasmin helps to ease the clinical symptoms possiblely through anti inflammation and decrease fibrinogen, and without obvious side effects.