摘要目的 观察创伤性肩关节前方不稳定患者肩峰下滑囊组织中IL-1、IL-1 β和TNF-α表达情况,研究其与疼痛程度的关系.方法 收集2017年1月至10月于本院住院拟行肩关节镜手术治疗的符合纳入标准的创伤性肩关节前方不稳定患者20例作为观察组,收集正常人20例作为对照组;两组入院后完善各项检查,观察组采用肩关节镜手术治疗,术中取肩峰下滑囊组织;对照组穿刺取肩峰下滑囊组织.采用Elisa法检测肩峰下滑囊组织中IL-1、IL-1β和TNF-α表达水平;采用qPCR法检测IL-1mRNA、IL-1β mRNA和TNF-αmRNA,采用VAS评分评价两组疼痛情况,采用相关性分析研究肩峰下滑囊组织中IL-1、IL-1β和TNF-α表达水平与VAS评分之间的相关性.结果 对照组IL-1、IL-1β和TNF-α含量分别为(21.22±3.69) pg/ml、(18.72±4.87) pg/ml、(26.33±6.67) pg/ml,观察组分别为(79.38±5.65) pg/ml、(61.12±4.77) pg/ml、(83.36±5.38) pg/ml,差异具有统计学意义(P＜0.01);对照组IL-1 mRNA、IL-1β mRNA和TNF-αmRNA含量分别为(0.18±0.04)、(0.16±0.07)、(0.37±0.08),观察组分别为(0.66±0.05)、(0.58±0.07)、(0.78±0.05),差异具有统计学意义(均P＜0.01);观察组VAS评分为(7.21±0.89)分,显著高于对照组的(0.56±0.03)分,差异具有统计学意义(P＜0.01);肩峰下滑囊组织中IL-1、IL-1β和TNF-α表达水平均与VAS评分呈正相关性.结论 创伤性肩关节前方不稳定患者肩峰下滑囊组织中发生炎症反应,炎性因子IL-1、IL-1 β和TNF-α表达水平与肩关节疼痛程度呈正相关性.

abstractsObjective To observe the expressions of IL-1,IL-1 beta and TNF-alpha in the acromion sac tissue of patients with traumatic anterior shoulder instability,and to study the relationship between them and the pain degree.Methods From January to October,2017,20 patients with acromion of traumatic shoulder anterior instability meeting the inclusion criteria and undergoing arthroscopic treatment at our hospital were collected and set as an observation group;and 20 normal persons were collected and set as a control group.Both groups took all the examinations after admission.The observation group were treated with arthroscopic surgery,and their subacromial bursa tissue was collected during the surgery.And the subacromial bursa tissue in the control group was collected by puncture.The expressions of IL-1,IL-1 beta,and TNF-alpha in the subacromial bursa tissue were detected by Elisa method.And qPCR method was used to detect IL-1 mRNA,IL-1 mRNA,and TNF-alpha mRNA.VAS score was used to evaluated the pain.Correlation analysis was used to study correlation of TNF-alpha,IL-1 beta,and IL-1 with pain degree in patients with acromion of traumatic shoulder anterior instability.Results The levels of IL-1,IL-1 beta,and TNF-alpha were (21.22±3.69) pg/ml,(18.72±4.87) pg/ml,and (26.33±6.67) pg/ml in the control group,and were (79.38±5.65) pg/ml,(61.12±4.77) pg/ml,and (83.36±5.38) pg/ml in the observation group,with statistical differences (all P ＜ 0.01).The levels of IL-1 mRNA,IL-1 beta mRNA,and TNF-alpha mRNA were (0.18±0.04),(0.16±0.07),and (0.37±0.08) the control group,and were (0.66±0.05),(0.58±0.07),and (0.78±0.05) in the observation group,with statistical differences (all P ＜ 0.01).The VAS score was (7.21±0.89) in the observation group,and was (0.56±0.03) in the control group,with a statistical difference (P ＜ 0.01).The expressions of IL-1,IL-1 beta and TNF-alpha in the acromion sac tissue positively correlated with VAS score.Conclusions Inflammatory reaction is found in the acromion sac tissue of patients with traumatic anterior shoulder instability.The expressions of IL-1,IL-1 beta,and TNF-alpha positively correlates with the degree of shoulder pain.