高强度运动对膝关节软骨组织病理学及关节液内生物标记物的影响  

Effect of high-intensity exercise on histopathology of knee joint cartilage and on levels of cartilage biomarkers in synovial fluid

作　　者：常祺[1] 黄昌林[1] 李芳芳[2] 

机构地区：[1]解放军第一五0中心医院,全军军事训练医学研究所,洛阳471031 [2]河南师范大学

出　　处：《中华创伤杂志》2007年第10期781-786,共6页Chinese Journal of Trauma

基　　金：全军医药卫生科研基金资助项目（06Q024）

摘　　要：目的 研究高强度运动对关节软骨病理组织学方面的影响，并了解基质金属蛋白酶-1（MMP-1）、基质金属蛋白酶-3（MMP-3）、基质金属蛋白酶抑制因子-1（TIMP-1）作为生物标记物在不同训练阶段的变化及其意义。方法 40只新西兰大白兔随机分为2组，对照组8只，笼内自由活动；训练组32只，每日行电刺激蹦跳训练。训练组动物与对照组动物分期分批抽取关节液并处死取材。应用ELISA方法检测关节液MMP-1、MMP-3、TIMP-1浓度。膝关节软骨做病理组织学检查，分别行光电镜显微观察以及葡萄糖胺聚糖（GAG）、关节软骨及软骨下骨厚度、坏死细胞率、Mankin病理学评分等检测。结果 显微观察显示训练组动物在训练4周时便开始有膝关节软骨过劳性损伤早期改变，8周时损伤改变进一步加重。4周时，训练组GAG含量与软骨下骨厚度明显低于对照组，Mankin评分明显高于对照组；8周时，训练组GAG含量、关节软骨及软骨下骨厚度明显低于对照组，坏死细胞率、Mankin评分明显高于对照组。训练组关节液内MMP-1、MMP-3、TIMP-1浓度在训练4周、8周均高于对照组，各标记物在关节液中浓度与各病理学检测指标间均有显著相关性。结论 高强度重复运动容易产生关节软骨运动性损伤，其始动因素为软骨基质的变性及流失；关节液内MMP-1、MMP-3、TIMP-1浓度变化可以很好地反映关节软骨过劳性损伤病理改变情况。Objective To study the effect of high-intensity exercise on histopathology of knee joint cartilage and investigate the changes of matrix metalloproteinase-1 （ MMP-1 ）, matrix metalloproteinase-3 （MMP-3） and tissue inhibitor of matrix metalloproteinase-1 （TIMP-1） in synovial fluid at different exercise stages. Methods A total of 40 New Zealand white rabbits were divided into control group （n=8） and training group （TG group, n = 32）. Animals in control group received no intervention but those in TG group were trained jumping in an electric stimulation cage daily. Concentrations of MMP-1, MMP-3, and TIMP-1 in synovial fluid were measured by ELISA assays at 4 and 8 weeks respectively. GAG （ glycosaminoglycan） content, thickness of cartilage and subchondral bone, necrotic cell ratio and Mankin grades were measured microscopically respectively. Results Microexamination showed early pathological changes of sport injury of articular cartilage in TG at the 4th week, which aggravated at the 8th week. In TG group, GAG content and thickness of subchondral bone were significantly lower but Mankin grades higher than those in control group at the 4th week. At the 8th week, GAG content, thickness of cartilage and subchondral bone, dead cell ratio and Mankin grades in TG group were significantly higher than those in control group. Levels of MMP-1, MMP-3, TIMP-1 and MMP-3/TIMP-1 in synovial fluid in TG group were significantly higher than those in control group at the 4th and 8th weeks. Furthermore, there was statistically significant correlation between biomarker levels in synovial fluid and chondropathological indices. Conclusions Repetitive and high-intensity exercises may easily induce sports injury in knee joint cartilage, when the initiating agent is the drain of cartilage matrix. Levels of MMP-1, MMP-3, TIMP-1 and MMP-3/TIMP- 1 in synovial fluid can well reflect pathological changes of cartilage injury.

关 键 词：软骨 关节 运动损伤 基质金属蛋白酶 生物标记物 

分 类 号：R686[医药卫生—骨科学]