影像学检查及细胞因子与膝骨关节炎患者病情活动的相关性研究  

The correlation study between disease activity and examinations of image and cytokines in patients with knee osteoarthritis

作　　者：张新玉 黄炳仓 吴墅 陈凯 陈庆 魏伟 魏丽 

机构地区：[1]上海浦东新区公利医院风湿科,上海200135 [2]上海浦东新区公利医院影像科,上海200135 [3]上海浦东新区公利医院检验科,上海200135

出　　处：《临床和实验医学杂志》2015年第13期1082-1085,共4页Journal of Clinical and Experimental Medicine

基　　金：上海浦东新区卫生局卫生科技项目(PW2012A-11)

摘　　要：目的采用磁共振成像(MRI)和高频超声对膝骨关节炎(OA)患者的滑膜病变、关节积液、软骨病变进行评价,研究细胞因子、WOMAC评分与滑膜厚度、软骨厚度、MRI软骨病变分级之间的相关性。方法将200例OA患者行膝MRI(滑膜炎、关节积液、软骨病变分级)、高频超声(滑膜炎、关节积液、滑膜厚度、软骨厚度)及完成WOMAC评分量表。依据MRI结果分为有滑膜炎组(A组:118例)、无滑膜炎组(B组:82例),选取同期体检的健康者作为对照组(C组:50例)。检测A组外周血及关节积液细胞因子(IL-1β、IL-6、IL-10、TNF-α)水平,检测B、C两组外周血细胞因子(IL-1β、IL-6、IL-10、TNF-α)水平。结果 MRI和超声对滑膜炎、关节积液、软骨病变诊断一致率分别为100%、98.88%、82.91%;A组TNF-α、IL-1β和IL-6水平明显高于B、C两组(P<0.05);A组超声下软骨厚度明显薄于B组(P<0.05);WOMAC评分A组明显高于B组(P<0.05);A组外周血/关节积液细胞因子和WOMAC评分与滑膜厚度及MRI软骨病变分级呈正相关(P<0.05)、与软骨厚度呈负相关(P<0.05)。结论 MRI和超声对OA膝关节病变均有较好的诊断作用;细胞因子(IL-1β、IL-6、TNF-α)在OA的滑膜病变、软骨病变中起关键作用。Objective To use magnetic resonance imaging（ MRI） and high- frequency ultrasound（ HFU） to evaluate synovium lesions,hydrops articuli and cartilage diseases and to analyze the relevance between cytokines,WOMAC score and synovial membrane thickness,cartilage thickness and the classification of cartilage diseases in knee osteoarthritis（ OA） patients. Methods Two hundred OA patients were examined by MRI on synovitis,hydrops articuli and the classification of cartilage diseases,and by HFU on synovitis,hydrops articuli,synovial membrane thickness and cartilage thickness. WOMAC score was evaluated. According to MRI results,the patients were divided into group A（ with synovitis,n =118） and group B（ without synovitis,n = 82）. Fifty healthy subjects were grouped in group C. IL- 1β,IL- 6,IL- 10 and TNF- α in peripheral blood and hydrops articuli were examined. Results The concordance rates of synovitis,hydrops articuli and cartilage diseases were 100%,98. 88%,and 82. 91%,respectively by MRI and HFU. TNF- α,IL- 1β and IL- 6 levels in group A were obviously higher than group B and group C（ P〈0. 05）. The cartilage thickness examined by HFU was obviously thinner in group A than group B（ P〈0. 05）. The WOMAC score of group A was obviously higher than group B（ P〈0. 05）. The cytokines in peripheral blood,hydrops articuli and WOMAC score in group A had positive correlation with synovial membrane thickness and classification of cartilage diseases（ P〈0. 05）,while had negative correlation with cartilage thickness（ P〈0. 05）. Conclusion Both MRI and HFU are helpful for OA diagnosis. IL- 1β,IL- 6 and TNF- α play important role in the pathological changes of synovial membrane and cartilage in patients with OA.

关 键 词：骨关节炎 磁共振成像 高频超声 滑膜炎 细胞因子 

分 类 号：R684.3[医药卫生—骨科学]