[1]童磊,贾锋,范丽,等.膝关节滑液白细胞介素1β、白细胞介素17、前列腺素E2含量与老年膝骨关节炎预后的关系研究…[J].中医正骨,2022,34(01):33-36.
 TONG Lei,JIA Feng,FAN Li,et al.The relationship between the prognosis of knee osteoarthritis and the contents of interleukin-1β,interleukin-17 and prostaglandin E2 in knee synovial fluid in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(01):33-36.
点击复制

膝关节滑液白细胞介素1β、白细胞介素17、前列腺素E2含量与老年膝骨关节炎预后的关系研究…()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年01期
页码:
33-36
栏目:
临床研究
出版日期:
2022-01-20

文章信息/Info

Title:
The relationship between the prognosis of knee osteoarthritis and the contents of interleukin-1β,interleukin-17 and prostaglandin E2 in knee synovial fluid in the aged
作者:
童磊贾锋范丽刘强
(南阳市中心医院,河南 南阳 473003)
Author(s):
TONG LeiJIA FengFAN LiLIU Qiang
Nanyang Central Hospital,Nanyang 473003,Henan,China
关键词:
骨关节炎 预后 老年人 滑液 白细胞介素1β 白细胞介素17 地诺前列酮
Keywords:
osteoarthritisknee prognosis aged synovial fluid interleukin-1beta interleukin-17 dinoprostone
摘要:
目的:探究膝关节滑液白细胞介素(interleukin,IL)-1β、IL-17、前列腺素E2(prostaglandin E2,PGE2)含量与老年膝骨关节炎(knee osteoarthritis,KOA)预后的关系。方法:选择110例老年KOA患者和60例单纯半月板损伤患者作为研究对象。入院后测定其膝关节滑液IL-1β、IL-17、PGE2含量。依据治疗6个月后的Lysholm膝关节评分评价KOA患者的预后,Lysholm评分≥70分为预后良好、Lysholm评分<70分为预后不良。比较老年KOA患者与单纯半月板损伤患者,以及老年KOA患者中预后良好者与预后不良者的膝关节滑液IL-1β、IL-17、PGE2含量。以老年KOA患者膝关节滑液IL-1β、IL-17、PGE2含量为自变量,以患者是否发生预后不良为因变量进行Logistic回归分析。采用受试者操作特征(receiver operating characteristic,ROC)曲线分析评价采用膝关节滑液IL-1β、IL-17、PGE2含量预测老年KOA预后的灵敏度、特异度、准确度,并测定曲线下面积(area under curve,AUC)。结果:老年KOA患者的膝关节滑液IL-1β、IL-17、PGE2含量均高于单纯半月板损伤者[(79.13±13.17)pg·mL-1,(24.89±4.15)pg·mL-1,t=34.018,P=0.000;(30.31±5.07)pg·mL-1,(11.05±1.85)pg·mL-1,t=30.906,P=0.000;(325.41±54.29)pg·mL-1,(207.96±34.71)pg·mL-1,t=15.785,P=0.000]。老年KOA患者中预后良好者的膝关节滑液IL-1β、IL-17、PGE2含量均低于预后不良者[(69.71±8.71)pg·mL-1,(86.32±10.79)pg·mL-1,t=8.183,P=0.000;(23.01±3.84)pg·mL-1,(39.63±6.61)pg·mL-1,t=16.195,P=0.000;(235.37±25.69)pg·mL-1,(366.31±38.73)pg·mL-1,t=20.282,P=0.000]。Logistic回归分析结果显示,膝关节滑液IL-1β、IL-17、PGE2含量均为老年KOA预后不良的危险因素[OR=3.117,95%CI(1.545,4.690); OR=4.899,95%CI(1.749,8.049); OR=5.376,95%CI(1.845,8.908)]。ROC分析结果显示,采用膝关节滑液IL-1β、IL-17、PGE2含量预测老年KOA预后的灵敏度分别为89.29%、82.14%、78.57%,特异度分别为85.37%、82.93%、76.83%,准确度分别为87.27%、85.45%、81.82%,AUC分别为0.815、0.801、0.780。结论:膝关节滑液IL-1β、IL-17、PGE2含量均为老年KOA预后不良的危险因素,也可作为预测老年KOA预后的指标。
Abstract:
Objective:To explore the relationship between the prognosis of knee osteoarthritis(KOA)and the contents of interleukin(IL)-1β,IL-17 and prostaglandin E2(PGE2)in knee synovial fluid in the aged.Methods:One hundred and ten aged patients with KOA and 60 patients with simple meniscus injury were selected out as the subjects,and the contents of IL-1β,IL-17 and PGE2 in their knee synovial fluid were measured after hospital admission.The prognosis of KOA was evaluated according to the Lysholm knee scores measured after 6-month treatment.The Lysholm score of≥70 points was classified as favorable prognosis,while the Lysholm score of<70 points as unfavorable prognosis.The contents of IL-1β,IL-17 and PGE2 in knee synovial fluid were compared between aged patients with KOA and patients with simple meniscus injury as well as between aged KOA patients with favorable prognosis and aged KOA patients with unfavorable prognosis.The Logistic regression analysis was conducted by taking the contents of IL-1β,IL-17 and PGE2 in knee synovial fluid as independent variable and whether unfavourable prognosis was occurred as dependent variable respectively.The prognoses of aged KOA patients were predicted using the contents of IL-1β,IL-17 and PGE2 in knee synovial fluid and the sensitivity,specificity and accuracy of prediction were analyzed and evaluated by using receiver operating characteristic(ROC)curve,and the area under curve(AUC)was measured.Results:The contents of IL-1β,IL-17 and PGE2 in knee synovial fluid were higher in aged patients with KOA compared to patients with simple meniscus injury(79.13±13.17 vs 24.89±4.15 pg/mL,t=34.018,P=0.000; 30.31±5.07 vs 11.05±1.85 pg/mL,t=30.906,P=0.000; 325.41±54.29 vs 207.96±34.71 pg/mL,t=15.785,P=0.000),whereas they were lower in aged KOA patients with favorable prognosis compared to patients with unfavorable prognosis(69.71±8.71 vs 86.32±10.79 pg/mL,t=8.183,P=0.000; 23.01±3.84 vs 39.63±6.61 pg/mL,t=16.195,P=0.000; 235.37±25.69 vs 366.31±38.73 pg/mL,t=20.282,P=0.000).The results of logistic regression analysis revealed that the contents of IL-1β,IL-17 and PGE2 in knee synovial fluid were the risk factors for unfavorable prognosis of KOA in aged patients(OR=3.117,95%CI(1.545,4.690); OR=4.899,95%CI(1.749,8.049); OR=5.376,95%CI(1.845,8.908)).The results of ROC analysis showed that the sensitivities of prediction of prognosis in aged KOA patients using the contents of IL-1β,IL-17 and PGE2 in knee synovial fluid were 89.29%,82.14% and 78.57%; the specificities were 85.37%,82.93% and 76.83%; the accuracies were 87.27%,85.45% and 81.82% respectively; and their AUC were 0.815,0.801 and 0.780 respectively.Conclusion:The contents of IL-1β,IL-17 and PGE2 in knee synovial fluid are the risk factors for unfavorable prognosis of KOA in aged patients,and they can also be used as the indexes for predicting prognosis of KOA in aged patients.

参考文献/References:

[1] HUSSAIN S M,NEILLY D W,BALIGA S,et al.Knee osteoarthritis:a review of management options[J].Scott Med J,2016,61(1):7-16.
[2] TAN C,ZHANG J,CHEN W,et al.Inflammatory cytokines via up-regulation of aquaporins deteriorated the pathogenesis of early osteoarthritis[J].PLoS One,2019,14(8):846.
[3] ZHENG X,ZHAO F C,PANG Y,et al.Downregulation of miR-221-3p contributes to IL-1β-induced cartilage degradation by directly targeting the SDF1/CXCR4 signaling pathway[J].J Mol Med(Berl),2017,95(6):615-627.
[4] WANG K,XU J,CAI J,et al.Serum levels of resistin and interleukin-17 are associated with increased cartilage defects and bone marrow lesions in patients with knee osteo-arthritis[J].Mod Rheumatol,2017,27(2):339-344.
[5] HARDY M M,SEIBERT K,MANNING P T,et al.Cyclooxygenase 2-dependent prostaglandin E2 modulates cartilage pro-teoglycan degradation in human osteoarthritis explants[J].Arthritis Rheum,2002,46(7):1789-1803.
[6] 徐卫东.骨关节炎的诊断与治疗[M].上海:第二军医大学出版社,2004:1154-1156.
[7] SMITH H J,RICHARDSON J B,TENNANT A.Modification and validation of the Lysholm knee scale to assess articular cartilage damage[J].Osteoarthritis Cartilage,2009,17(1):53-58.
[8] 中华医学会骨科学分会关节外科学组,中国医师协会骨科医师分会骨关节炎学组,国家老年疾病临床医学研究中心(湘雅医院),等.中国骨关节炎诊疗指南(2021年版)[J].中华骨科杂志,2021,41(18):1291-1314.
[9] LIU C,REN S,ZHAO S,et al.LncRNA MALAT1/MiR-145 adjusts IL-1β-induced chondrocytes viability and cartilage matrix degradation by regulating ADAMTS5 in human osteoarthritis[J].Yonsei Med J,2019,60(11):1081-1092.
[10] KIM E K,KWON J E,LEE S Y,et al.IL-17-mediated mitochondrial dysfunction impairs apoptosis in rheumatoid arthritis synovial fibroblasts through activation of auto-phagy[J].Cell Death Dis,2017,8(1):2565.
[11] XIAO W F,LI Y S,DENG A,et al.Functional role of hedgehog pathway in osteoarthritis[J].Cell Biochem Funct,2020,38(2):122-129.
[12] 尹万乐,马利阁,尤笑迎,等.膝骨性关节炎患者关节滑液白细胞介素-1β和肿瘤坏死因子-α的表达及意义[J].中华实验外科杂志,2017,34(9):1593-1595.
[13] LEI J,FU Y,ZHUANG Y,et al.LncRNA SNHG1 alleviates IL-1β-induced osteoarthritis by inhibiting miR-16-5p-mediated p38 MAPK and NF-κB signaling pathways[J].Biosci Rep,2019,39(9):1523.
[14] QIU W J,XU M Z,ZHU X D,et al.MicroRNA-27a alleviates IL-1β-induced inflammatory response and articular cartilage degradation via TLR4/NF-κB signaling pathway in articular chondrocytes[J].Int Immunopharmacol,2019,76:105839.
[15] 陈滢宇,姜薇,韩小雪,等.中药“艾辛痛方”外用治疗膝骨性关节炎临床观察及对细胞因子IL-17调节作用初探[J].中国中医基础医学杂志,2019,25(4):509-512.
[16] 李慧,曾明珠,张瑜.补肾强筋胶囊对早中期膝骨性关节炎滑液中白细胞介素-1β、肿瘤坏死因子-α、前列腺素E2及血清前列腺素E2的影响[J].中国医药导报,2019,16(15):119-123.

相似文献/References:

[1]樊庆阳,任凯晶.定制3D打印切模辅助全膝关节置换术治疗 膝骨关节炎合并股骨干骨折畸形愈合[J].中医正骨,2015,27(11):37.
[2]刘晓雅,孙永强,刘国杰.主动快速康复锻炼对全膝关节置换术后关节活动度的影响[J].中医正骨,2015,27(09):73.
[3]郑春松,叶蕻芝,李西海,等.透骨消痛胶囊中补肾柔肝药和活血祛风药治疗 骨关节炎作用方式的计算机模拟比较[J].中医正骨,2015,27(07):6.
 ZHENG Chunsong,YE Hongzhi,LI Xihai,et al.Comparison of the mode of action of Bushen Rougan(补肾柔肝)drugs versus Huoxue Qufeng(活血祛风)drugs contained in Tougu Xiaotong Jiaonang(透骨消痛胶囊)for the treatment of osteoarthritis:A computer simulation study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(01):6.
[4]宋兵华,孙俊英,倪增良,等.全膝关节置换术前CT测量股骨后髁角的临床意义[J].中医正骨,2015,27(07):38.
[5]郑春松,叶蕻芝,李西海,等.独活寄生汤含药血清对白细胞介素1β诱导的 退变关节软骨细胞中基质金属蛋白酶 和环氧化酶2表达的影响[J].中医正骨,2015,27(12):1.
 ZHENG Chunsong,YE Hongzhi,LI Xihai,et al.Impact of Duhuo Jisheng Tang(独活寄生汤)medicated serum on expression of matrix metalloproteinase and cyclooxygenase 2 in degenerative articular chondrocytes induced by interleukin-1 beta[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(01):1.
[6]王金良,孙京涛,李玲,等.骨水泥联合螺钉修复全膝关节置换术中 胫骨平台内侧骨缺损[J].中医正骨,2015,27(12):55.
[7]冯荣,王平,李炳奇,等.铍针刺络拔罐结合中药口服治疗膝骨关节炎合并 原发性血小板增多症1例[J].中医正骨,2015,27(12):73.
[8]蔡云仙.围手术期耳穴按压联合平衡针疗法 在全膝关节置换术后镇痛中的应用[J].中医正骨,2015,27(06):41.
[9]张荣,王健.人工全膝关节置换术的围手术期心理护理[J].中医正骨,2015,27(05):77.
[10]喻长纯,杨明路,王战朝.不同手术方式治疗胫骨平台骨折畸形愈合的体会[J].中医正骨,2015,27(03):37.
[11]孟维娜,明立功,王新德,等.关节镜下清理联合腓骨近1/3段截骨治疗膝骨关节炎[J].中医正骨,2015,27(11):40.
[12]明立功,孟维娜,王新德,等.腓骨近端截骨治疗内侧间室膝骨关节炎的近期疗效观察[J].中医正骨,2015,27(10):25.
[13]张杰,王人彦,张玉柱.膝骨关节炎的治疗进展[J].中医正骨,2015,27(10):68.
[14]梁朝,蔡静怡,闫立,等.针刀疗法改善膝骨关节炎早期疼痛症状的疗效评价[J].中医正骨,2015,27(09):9.
 LIANG Zhao,CAI Jingyi,YAN Li,et al.Evaluation of the curative effect of needle-knife therapy for relieving knee pain in patients with early knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(01):9.
[15]王建武,党建军,李强,等.四联疗法治疗膝骨关节炎[J].中医正骨,2015,27(08):44.
[16]刘红娟,郭会利,郭树农.云克联合中药治疗膝骨关节炎的护理[J].中医正骨,2015,27(08):75.
[17]陈卫衡.探索建立系统的膝骨关节炎中医临床科研范式 和理论体系[J].中医正骨,2015,27(07):1.
[18]帅波,沈霖,杨艳萍,等.加味青娥丸治疗膝骨关节炎的作用机制研究[J].中医正骨,2015,27(07):15.
 SHUAI Bo,SHEN Lin,YANG Yanping,et al.Study on the mechanism of action of Jiawei Qing'e Wan(加味青娥丸)for the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(01):15.
[19]梅其杰,袁长深,段戡,等.壮药骨痹方烫熨联合运动疗法治疗膝骨关节炎的临床研究[J].中医正骨,2015,27(07):27.
 MEI Qijie,YUAN Changshen,DUAN Kan,et al.Clinical study of the curative effect of hot compressing and rubbing with packet of Gubi Fang(骨痹方)combined with exercise therapy in the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(01):27.
[20]王丹辉,张燕,刘丽娟,等.重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白 关节腔注射联合中药薰洗治疗膝骨关节炎的临床研究[J].中医正骨,2015,27(07):31.
 WANG Danhui,ZHANG Yan,LIU Lijuan,et al.Clinical study on intra-articular injection of TypeⅡrecombinant human tumor necrosis factor receptor-Fc fusion protein combined with Chinese herbal steaming and washing therapy for treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(01):31.

备注/Memo

备注/Memo:
基金项目:河南省医学科技攻关计划项目(2018020579)
更新日期/Last Update: 1900-01-01