生化因素在内翻膝骨关节炎患者外侧间室软骨磨损中的作用
Roles of biochemical factors in lateral compartment wear from varus knee osteoarthritis
目的 探讨生化因素在内翻膝性骨关节炎(OA)外侧间室软骨磨损中的作用.方法 前瞻性收集2013年6月至2014年6月中日友好医院骨关节外科全膝关节表面置换术治疗的内翻膝OA患者外侧间室软骨磨损的临床资料,术前关节穿刺抽取关节液,截骨标本进行病理学分析.根据配对原则,选取相同数量外侧间室无磨损的病例(对照组)进行对照研究.采用酶联免疫吸附试验对关节液二型胶原羟基酸肽(CTX-Ⅱ)、白细胞介素(IL)6、基质金属蛋白酶(MMP) 13含量进行检测.结果 内翻膝OA,无论外侧间室软骨磨损与否,外侧间室软骨病理镜下均有退变,但是对照组外侧间室软骨全层存在.内翻膝OA患者外侧间室磨损组,关节液中CTX-Ⅱ、IL-6、MMP-13分别为(111.8±55.7)、(2.5±1.0) ng/L、(134.4±33.1)μg/L.对照组关节液中CTX-Ⅱ、IL-6、MMP-13分别为(91.7±57.1)、(2.1 +0.5)ng/L、(122.7±28.3) μg/L.外侧间室磨损组虽然较对照组稍高,但差异均无统计学意义(均P >0.05).结论 内翻膝OA无论外侧间室软骨磨损与否,病理学外侧间室软骨均有退变.在内翻膝OA,生化因素可能仅能使外侧间室软骨退变,而在软骨磨损中却不起主要作用.
更多Objective To explore the roles of type Ⅱ collagen C-terminal telopeptide (CTX-Ⅱ),matrix metalloproteinase-13 (MMP-13) and interleukin-6 (IL-6) in lateral compartment wear in varus knee osteoarthritis.Methods Prospective reviews were conducted for the clinical data of varus knee osteoarthritis patients with lateral compartment wear undergoing total knee arthropalsty from June 2013 to June 2014.The gross findings of lateral compartment articular cartilage were recorded intraoperatively.And the slices were evaluated histologically.Synovial fluid was obtained by arthrocentesis.An equal number of operative patients from varus knee osteoarthritis without lateral compartment wear during the same period were selected and matched with respects to age,varus,preoperative range of motion and radiological grade of knee arthrosis.Synovial fluid concentrations of CTX-Ⅱ,MMP-13 and IL-6 were evaluated.Results Histologic examination showed microscopic cartilage degeneration in both groups.The concentrations of CTX-Ⅱ,IL-6 and MMP-13 in synovial fluid from lateral compartment wear group were (111.8 ± 55.7) ng/L,(2.5 ± 1.0) ng/L and (134.4 ± 33.1) μg/L respectively.And there were no differences with control group (91.7±57.1) ng/L,(2.1 ±0.5) ng/L,(122.7 ±28.3) μg/L respectively.Conclusion The above biochemical factors may not play key roles in lateral compartment wear of varus knee osteoarthritis.
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