玻璃酸钠注射膝骨关节炎关节液中一氧化氮及滑膜厚度的变化  

Effect of sodium hyaluronate on nitric oxide and synovial thickness in patients with knee osteoarthritis

作　　者：邓剑锋[1] 高大新[1] 刘志新[1] 吴迪[1] 宋红[1] 严佳亮 齐曦明[1] 孙凤丽[1] 赵淑玲[1] 

机构地区：[1]秦皇岛市第一医院骨科,河北省秦皇岛市066000

出　　处：《中国组织工程研究》2014年第52期8520-8524,共5页Chinese Journal of Tissue Engineering Research

基　　金：河北省科学技术研究与发展计划项目(132777102D)~~

摘　　要：背景:关节腔内注射玻璃酸钠已成为膝骨关节炎的预防和补充疗法,可有效缓解疼痛,保护关节软骨,恢复关节功能。目的:观察关节腔内注射玻璃酸钠对膝骨关节炎关节液中一氧化氮水平、滑膜厚度的影响。方法:随机选择膝骨关节炎患者80例(86膝),根据日本膝骨关节炎指征等级分为轻、中、重度3组,关节腔内每周注射1次玻璃酸钠25 mg,连续5周。治疗4,12周后按照日本膝骨关节炎指征等级对所有患者治疗前后行临床评分;将在4周后还能抽出关节液和完成超声测定的37例(40膝)患者定为完整监测组,亦分轻、中、重度3组,测定治疗前和治疗4周后关节液一氧化氮水平和滑膜厚度。结果与结论:治疗4周后,轻、中、重度组有效率分别为93%,77%,47%,总有效率为79%;治疗12周后,轻、中、重度组有效率分别为95%,84%,33%,总有效率为80%。膝骨关节炎完整监测组中,轻、中、重度组治疗4周后关节液一氧化氮水平较治疗前明显下降(P<0.05),轻、重度组治疗4周后滑膜厚度与治疗比较差异无显著性意义(P>0.05),中度组治疗4周后滑膜厚度较治疗前减少(P<0.05)。表明玻璃酸钠治疗膝骨关节炎可降低患膝关节液一氧化氮水平,改善临床疗效,对轻、中度膝骨关节炎患者为佳。BACKGROUND： Intra-articular injection of sodium hyaluronate has become a preventive and complementary therapy for knee osteoarthritis that can effectively relieve pain, protect the articular cartilage, and restore the joint function. OBJECTIVE： To observe the effects of sodium hyaluronate on nitric oxide and synovial thickness in patients with knee osteoarthritis. METHODS： Eighty patients with knee osteoerthritis （86 knees） were randomly selected and divided into mild, moderate, severe groups, tntra-articular injection of 25 mg sodium hyaluronate was done once a week for 5 consecutive weeks. At 4 and 12 weeks after treatment, all the patients were subjected to clinical scoring according to the Japanese Knee Osteoarthritis Measure. Thirty-seven patients （40 knees） who could make joint fluid and complete ultrasonic measurement was taken as a complete monitoring group that was also divided into three groups of mild, moderate, and severe. Levels of nitric oxide and synovial thickness were measured before and at 4 weeks after treatment. RESULTS AND CONCLUSION： At 4 weeks after treatment, the effective rates of mild. moderate and severe groups were 93%, 77% and 47 %, respectively, and the total effective rate was 79%. At 12 weeks after treatment, the effective rates of mild, moderate and severe groups were 95%, 84% and 33 %, respectively, and the total effective rate was 80%. In the complete monitoring group, the level of nitric oxide was reduced significantly in mild, moderate and severe patients at 4 weeks after treatment compared with before treatment （P 〈 0.05）, but the synovial thickness had no difference in the mild and severe patients, and only moderate patients appeared to have thinner synovial thickness compared with before treatment （P 〈 0.05）. Experimental findings suggest that sodium hyaluronate can reduce the level of nitric oxide and improve clinical efficacy in patients with knee osteoporosis, especially for mild and moderate knee osteoporosis patients.

关 键 词：生物材料 骨生物材料 骨关节炎 玻璃酸钠 滑膜 一氧化氮 

分 类 号：R318[医药卫生—生物医学工程]