骨性关节炎患者三种细胞因子水平及透明质酸钠治疗对其水平的影响  

LEVELS OF 3 CYTOKINES IN PATIENTS WITH OSTEOARTHRITIS AND THEINFLUENCE OF SODIUM HYALURONATE

作　　者：汤建平[1] 吕征[1] 曹晓健[1] 

机构地区：[1]南京医科大学附属第一医院风湿免疫科

出　　处：《中国新药杂志》1999年第7期467-468,共2页Chinese Journal of New Drugs

摘　　要：目的：探讨骨性关节炎患者血清与滑膜液中ＩＬ１，ＩＬ６，ＴＮＦａ水平变化及关节腔注射透明质酸钠对其影响。方法：取２２例有膝关节腔积液的骨性关节炎患者随机分成两组：治疗组予透明质酸钠２ｍｌ膝关节腔注射，１０ｄ一次，连用５次，对照组予功能锻炼，非甾体药物口服止痛治疗，观察相同疗程即５０ｄ。两组病例分别测定治疗前后血清与滑膜液中ＩＬ１，ＩＬ６，ＴＮＦａ水平，为常规ＥＬＩＳＡ法。用双因素比较ｔ检验与直线相关回归进行统计分析。结果：治疗前治疗组与对照组滑膜液中ＩＬ１，ＩＬ６，ＴＮＦａ水平均高于血清，分别呈正相关，有统计差异。治疗后治疗组滑膜液中ＩＬ１，ＩＬ６，ＴＮＦａ水平均下降，而对照组无变化。治疗后治疗组血清中ＩＬ１，ＩＬ６水平均下降，但ＴＮＦａ无变化。结论：骨性关节炎发病机制与关节滑膜细胞分泌过多的ＩＬ１，ＩＬ６，ＴＮＦａ并释放入血有关。透明质酸钠关节腔注射可降低血清与滑膜液中ＩＬ１，ＩＬ６，ＴＮＦａ水平，抑制免疫损害进程，有较好的治疗作用。OBJECTIVE :To investigate level changes in serum and synovial fluid of IL1,IL6 and TNFa in osteoarthritis patients and the influences of sodium hyaluronate. METHODS :22 patients with osteoarthritis having hydrops in knee joint cavity were randomized to receive 2 ml sodium hyaluronate intraarticular injection once 10d for 5 times or functional training plus NSAI therapy for 50 days.In both arms,the level changes in serum and synovial fluid of IL1,IL6,and TNFa were measured by ELISA before and after therapy.In statistical analysis the t test between 2 factors and lineal relative recurrence were adopted. RESULTS :In both arms,the titers of IL1,IL6 and TNFa in synovial fluid before therapy were higher than the corresponding titers in serum (P<0.01).In active arm,the titers of IL1,IL6,and TNFa in synovial fluid after therapy were lower than before therapy but no change in control arm.In active arm,the serum titers of IL1 and IL6 after therapy were lower than before therapy,but no change in TNFa titer. CONCLUSION :The pathogenesis of osteoarthritis is linked to higher titers in serum and synovial fluid of IL1,IL6 and TNFa secreted by articular synovial cells.Titers in synovial fluid of IL1,IL6 and TNFa;and titers in serum of IL1 and IL6 can be decreased by intraarticular injection of sodium hyaluronate and the immunopathological lesion progress can be inhibited.

关 键 词：骨性关节炎 透明质酸钠 关节腔注射 治疗 

分 类 号：R684.305[医药卫生—骨科学]