膝关节骨关节炎滑液和软骨骨桥蛋白水平与其病变程度的相关性  

Correlation of synovial fluid and articular cartilage osteopontin with disease severity in knee osteoarthritis

作　　者：高曙光[1] 徐文硕[1] 曾凯斌[1] 涂敏[1] 徐迈[1] 罗伟[1] 李康华[1] 雷光华[1] 

机构地区：[1]中南大学湘雅医院骨科中南大学骨科研究所,长沙410008

出　　处：《中华骨科杂志》2010年第7期672-676,共5页Chinese Journal of Orthopaedics

基　　金：国家自然科学基金（30300396）,湖南省发展与改革委员会基金（20070105）,中南大学研究生创新项目

摘　　要：目的探讨膝关节骨关节炎（osteoarthritis，OA）患者滑液和关节软骨骨桥蛋白（osteopontin，OPN）水平及其与病变严重程度的关系。方法随机选取50例膝关节OA患者[男15例，女35例；年龄48-81岁，平均（61．8±7．4）岁]和10名健康对照者[男4例，女6例；年龄59-68岁，平均年龄（63．2±6．0）岁]作为研究对象。采用Mankin评分评价疾病严重程度，Kellgren—Lawrence标准进行放射学分级，酶联免疫吸附法测定关节滑液OPN水平，免疫组化方法测定关节软骨OPN光密度值。结果OA患者与对照者相比，关节滑液OPN水平[（4519．60±1830．37）pg／ml：（1179．70±303．39）pg／m1）和关节软骨OPN光密度值[（0．60±0．06）：（0．43±0．07）]均明显升高。关节滑液OPN水平与关节软骨OPN表达呈正相关（r=0．411，P=0．003）。关节滑液OPN水平与OA病变严重程度（KL分级）呈正相关（r=0．581，P〈0．001）。关节软骨OPN表达与OA病变严重程度（Mankin评分）呈正相关（r=0．675，P〈0．001）。结论关节滑液和关节软骨OPN水平与病变严重程度相关。Objective To examine osteopontin （OPN） levels in both synovial fluid and articular cartilage of patients with primaly knee osteoarthritis （OA） and to investigate their relationship with severity of the disease. Methods Fifty patients with knee OA and 10 healthy controls were enrolled in this study. There were 15 males and 35 females with an average age of 61.8±7.4 years in OA group. The control group included 4 males and 6 females with an average age of 63.2±6.0 years. Mankin score were taken to determine the disease severity of the affected knee. The radiographic grading of OA in the knee was performed using the Kellgren-Lawrence criteria. OPN levels in synovial fluid were measured using enzyme-linked im- munosorbent assay. OPN levels in articular cartilage were assessed by immunohistochemical methods. Resuits Compared to healthy controls, the knee OA patients had higher OPN concentration in synovial fluid [4519.60±1830.37] pg/ml vs. [1179.70±303.39] pg/ml） and articular cartilage（[0.60＋0.06] vs. [0.43±0.07]）. In addition, synovial fluid OPN levels showed a positive correlation with articular cartilage OPN levels （r=0.411, P=0.003）. Subsequent analysis showed that the OPN levels in synovial fluid significantly had been correlated with severity of disease using Kellgren-Lawrence criteria （r=0.581, P〈 0.001）. Furthermore ,the levels of OPN in the articular cartilage also were correlated with disease severity using Mankin score （r=0.675, P〈 0.001）. Conclusion The data suggest that OPN in synovial fluid and articular cartilage is related to progressive joint damage and could be a predictive biomarker respect to disease severity and progression in knee OA.

关 键 词：骨桥蛋白质 骨关节炎 膝 滑液 软骨 关节 

分 类 号：R684.3[医药卫生—骨科学]