生物填充疗法治疗西藏大骨节病患者血清细胞因子水平和疗效观察  

Investigation on Efficacy and Serum cytokine level of Patients with Kashin-Beck Disease treated by Bio-filled Therapy in Tibet

作　　者：刘丽军[1] 张晓慧 魏大河 王海耀 徐世林 扎西桑珠 龚宏强 胡抗[1] 陈锋[1] 康龙丽[1] 

机构地区：[1]西藏民族学院医学院高原环境与疾病相关基因研究重点实验室 [2]西藏民族学院附属医院,陕西咸阳712082 [3]西藏地方病研究所,西藏拉萨850000

出　　处：《西藏大学学报（社会科学版）》2011年第6期56-59,121,共5页Journal of Tibet University

基　　金：科技部科技支撑计划项目"中医药防治大骨节病"(项目号:2007BAI25B05);教育部重点项目"大骨节病患者CNV多态性研究"(项目号:208138);国家民委项目"传统藏医药和生物填充疗法治疗大骨节病"(项目号:XZ200802)阶段性成果

摘　　要：目的:分析西藏大骨节病患者用生物填充剂透明质酸钠膝关节注射治疗前后血清中细胞因子水平的变化与治疗效果。方法:选择西藏拉萨地区尼木县、墨竹工卡县、林周县等大骨节病区患者和病区健康对照组成人共252例为调查对象,依据大骨节病诊断标准,将其分为大骨节病组(KBD组,156例)和健康对照组(96例),患者平均年龄和性别无差别。KBD组中106例膝关节注射透明质酸钠,50例口服Vc。采用ELISA法测定血清中白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、透明质酸(HA)水平,硝酸还原酶法测定一氧化氮含量。结果:注射治疗后一周症状明显缓解,且疗效显著优于口服Vc。大骨节病组血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)一氧化氮含量等显著高于对照组人群,但透明质酸含量低于对照组。治疗后三个月血清细胞因子水平有下降趋势,但无统计学显著性。结论:膝关节注射生物填充剂透明质酸钠治疗西藏大骨节病,可缓解临床症状,改善关节功能,其作用可能是通过润滑关节,降低血清滑液中炎性细胞因子如TNF-1α、IL-1β等水平的作用来实现。The serum cytokine level and clinical efficacy of patient with KBD were analyzed after treated with Bio-filled therapy in Tibet.According to standard diagnosis of Kashin-Becking disease,156 patients with KBD as experimental group and 96 healthy as control group were selected from Nimu county,Linzhou county and Mozhugongka county in Lhasa.106 patients were given Sodium hyaluronate（SH） by knee injection,and 50 given Vitamin C in Treatment group.The level of Interleukin-1β（IL-1β）,Tumor necrosis factor-α（TNF-α）,Hyaluronic Acid（HA） were detected by ELISA,and Nitrous oxide（No） was detected by Nitrate reductase,respectively.The results showed that the symptom was obviously relieved after injection SH in one week and efficacy was better than oral Vc.IL-1β,TNF-α,and No levels were in experimental group higher than control group,but HA level was lower than that of control group.There was decreasing trend in cytokines level after three months treatment,but no statistically significant.Injection bio-filler-SH has effects for improving knees function of patients and relieve clinical their symptom of KBD in Tibet and.Possibly reduction of TNF-1,IL-1βlevels of cytokine can lubricate joints.

关 键 词：大骨节病(KBD) 透明质酸钠(SH) 白细胞介素-1β(IL-1β) 肿瘤坏死因子 

分 类 号：R684.1[医药卫生—骨科学]