目的 探讨司库奇尤单抗联合艾拉莫德对强直性脊柱炎（AS）患者血清骨硬化蛋白（SOST）、Dickkopf-1相关蛋白（DKK-1）、Ⅰ型胶原蛋白C末端肽（CTX-Ⅰ）水平及脊柱功能的改善作用。 方法 选取2023年1月至2024年12月青岛市第五人民医院收治的150例AS患者作为研究对象，采用随机数字表法分为A组（50例）、B组（50例）和C组（50例），其中A组失访2例，B组失访1例，C组失访1例，最终纳入A组（48例）、B组（49例）和C组（49例）。A组给予艾拉莫德，B组给予司库奇尤单抗，C组给予司库奇尤单抗联合艾拉莫德。3组均连续治疗6个月。比较3组治疗6个月后的临床疗效，治疗前、治疗6个月后的脊柱功能、晨僵持续时间、疾病活动度、磁共振成像（MRI）骶髂关节评分、炎症反应及血清SOST、DKK-1、CTX-Ⅰ水平，治疗期间的安全性。 结果 治疗6个月后，C组总有效率为93.88%，高于A、B组的60.42%、79.59%，B组高于A组（P < 0.05）。与治疗前比较，治疗6个月后，3组Bath AS功能指数（BASFI）、巴氏AS疾病活跃状况量表（BASDAI）、MRI骶髂关节评分、血清C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、DKK-1、CTX-Ⅰ水平均降低，且C组低于A、B组，B组低于A组；3组晨僵持续时间均缩短，且C组短于A、B组，B组短于A组；3组血清SOST水平均升高，且C组高于A、B组，B组高于A组（P < 0.05）。3组治疗期间不良反应发生率比较差异无统计学意义（P > 0.05）。 结论 相比于单一治疗，司库奇尤单抗联合艾拉莫德可显著缓解AS患者疾病症状，减轻患者炎症反应，并有效调节患者血清SOST、DKK-1、CTX-Ⅰ水平，改善患者脊柱功能，进而提高临床疗效，不会增加患者不良反应的发生，而司库奇尤单抗单一治疗的效果优于艾拉莫德单一治疗。

Objective To investigate the enhancing effect of sikuximab in combination with iguratimod on the serum levels of osteopontin （SOST）， Dickkopf-1 related protein （DKK-1）， type Ⅰ collagen C-terminal peptide （CTX-I）， and spinal function in patients with ankylosing spondylitis （AS）. Methods A total of 150 patients with AS who were admitted to our hospital from January 2023 to December 2024 were selected as the research subjects. They were randomly assigned to three groups， namely Group A （50 cases）， Group B （50 cases）， and Group C （50 cases）， using the random number table method. Among them， 2 cases in Group A， 1 case in Group B， and 1 case in Group C were lost to follow-up. Finally， 48 cases were included in Group A， 49 cases in Group B， and 49 cases in Group C. Group A received iguratimod， Group B received sikuximab， and Group C received sikuximab in combination with iguratimod. All three groups received continuous treatment for 6 months. The clinical efficacy after 6 months of treatment was compared among the three groups， including spinal function before and after treatment， duration of morning stiffness， disease activity， magnetic resonance imaging （MRI） sacroiliac joint score， inflammatory response， and levels of serum SOST， DKK-1， CTX-I before and after 6 months of treatment， as well as safety during treatment. Results After 6 months of treatment， the total effective rate of group C was 93.88%， which was higher than those of group A （60.42%） and group B （79.59%）. Moreover， the total effective rate of group B was higher than that of group A （P < 0.05）. Compared with the pre - treatment values， after 6 months of treatment， the Bath AS Functional Index （BASFI）， Bartholomew's AS Disease Activity Inventory （BASDAI）， MRI sacroiliac joint scores， the levels of serum C-reactive protein （CRP）， tumor necrosis factor - α （TNF-α）， interleukin-1β （IL-1β）， DKK-1， and CTX-I in all three groups decreased. The values in group C were lower than those in group A and group B， and the values in group B were lower than those in group A. The duration of morning stiffness in all three groups was shortened. The duration in group C was shorter than those in group A and group B， and the duration in group B was shorter than that in group A. The levels of serum SOST in all three groups increased. The levels in group C were higher than those in group A and group B， and the levels in group B were higher than those in group A （P < 0.05）. There were no significant differences in the incidences of adverse reactions among the three treatment groups （P > 0.05）. Conclusions Compared to monotherapy， the combination of sikuximab and iguratimod can significantly alleviate the symptoms of patients with AS， reduce their inflammatory response， effectively regulate the levels of serum SOST， DKK-1， and CTX-I， improve spinal function， and enhance clinical efficacy without increasing the incidence of adverse reactions. Nevertheless， sikuximab monotherapy is more effective than iguratimod monotherapy.