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目的 初步探讨骨关节炎(OA)骨桥蛋白(OPN)及其下游产物与骨关节炎影像学的关系.方法 采用酶联免疫吸附法(ELISA)检测22例OA患者血清和膝关节滑液中及21例健康人血清中OPN和凝血酶切割的骨桥蛋白(NTOPN)水平,分析其与影像学及各临床指标的相关性.结果 OA患者血清OPN水平为(1.7±1.1)μg/L,略低于健康人[(1.8±0.5)μg/L];OA患者血清NTOPN水平为(21.1±11.7) μg/L,明显高于健康人[(14.7±3.6) μg/L;P＜0.05],女性OA者血清中NTOPN水平为(23.2±11.8)μg/L,高于男性[(11.1±4.9)μg/L;P＜0.05].OA患者膝关节滑液中OPN水平为(7.75±2.33) pg/L,NTOPN水平为(0.91±0.49) μg/L; NTOPN/OPN为0.12±0.08.OA患者血清OPN水平与C反应蛋白呈正相关(r=0.574,P=0.005);OA患者膝关节滑液中NTOPN/OPN与骨关节炎Kellgren-Lawrence分级呈正相关(r=0.535,P=0.022).结论 血清OPN水平与全身炎症程度相关,膝关节液中OPN向NTOPN的转化率与OA严重程度相关,NTOPN作为OPN的下游产物可能参与OA发病,NTOPN是否可作为OA关节病变程度及炎症状态的预测指标值得进一步探讨.

Objective To explore the relationship between osteopontin (OPN),its downstream product thrombin-cleaved osteopontin (NTOPN) and radiographic changes in osteoarthritis (OA).Methods The levels of OPN and NTOPN in serum and synovial fluid were tested by enzyme-linked immuno sorbent assay (ELISA) kit in 22 OA patients and 21 health controls.The correlation between the above parameters and clinical data such as radiology changes of OA patients was analyzed.Results The serum level of OPN in the OA group was positively correlated with C reactive protein (CRP) (r =0.574,P =0.005).The serum level of OPN in the OA group was slightly lower than that in the healthy control group [(1.8 ± 0.5) μg/L vs (1.7 ± 1.1) μg/L,P ＞ 0.05].Similarly,the serum level of NTOPN in the OA group was significantly higher than that in control group [(21.1 ± 11.7) μg/L vs (14.7 ± 3.6) μg/L,P ＜ 0.05].Meanwhile,serum NTOPN level in female patients was significantly higher than that in male patients [(23.2 ± 11.80) μg/L vs (11.1 ± 4.9) μg/L,P ＜ 0.05].In synovial fluid of OA group,the level of OPN was (7.75 ± 2.33) μg/L,NTOPN was (0.91 ± 0.49) μg/L and the ratio of NTOPN/OPN was 0.12 ± 0.08.The level of OPN of synovial fluid in the OA group was positively correlated with CRP (r =0.574,P =0.005).NTOPN-to-OPN ratio of synovial fluid in the OA group was positively correlated with Kellgren-Lawrence grade (r =0.535,P =0.022).Conclusions The serum level of OPN is correlated with severity of inflammation in the OA patients.Meanwhile,NTOPN-to-OPN ratio of synovial fluid is correlated with OA severity.As a downstream bioactive product of OPN,NTOPN may play an important role in OA pathogenesis.Whether these parameters can be used as predictors of joint lesion severity and inflammatory status is worth further study.