关节液YKL-40水平与骨关节炎的相关性研究  

Correlation between synovial fluid YKL-40 and extent of osteoarthritis

作　　者：关健[1] 李锋[1] 宋永周[2] 丁罗宾[1] 谢磊[1] 王华军[3] 

机构地区：[1]石家庄市第三医院关节外科,石家庄050000 [2]河北医科大学第二医院骨科,石家庄050000 [3]暨南大学第一临床医学院暨南大学附属第一医院骨关节外科,广州市510630

出　　处：《中国矫形外科杂志》2017年第21期1993-1996,共4页Orthopedic Journal of China

基　　金：河北省石家庄市科技支撑计划课题(编号:151460433A);中国博士后科学基金资助项目(编号:2015M582480);广东省自然科学基金项目(编号:2016A030313100);国家自然科学基金项目(编号:81601219)

摘　　要：[目的]探讨膝骨关节炎患者关节液中YKL-40水平与膝关节病变程度的相关性,为关节炎的早期诊断提供新的思路和临床依据。[方法]114例骨关节炎患者,WOMAC评分系统评估患者临床症状程度,X线K-L分级方法评估影像改变程度。抽取患膝关节滑液,采用双抗夹心酶联免疫吸附法检测关节滑液中YKL-40的水平。采用秩相关分析的多元相关分析YKL-40水平与骨性关节炎程度的相关性。[结果]不同K-L分期组滑液YKL-40水平差异有统计学意义,Ⅳ级患者高于Ⅲ级患者,Ⅲ高于Ⅱ级患者(P<0.05),秩相关分析显示,滑液SYKL-40水平与患者X线K-L分级呈正相关(r=0.542,P<0.001)。此外,秩相关分析显示,滑液YKL-40水平与WOMAC疼痛(r=0.517,P=0.001)、肢体功能(r=0.380,P=0.025)以及总分(r=0.407,P=0.010)呈正相关,但与WOMAC关节僵硬评分无明显相关性(r=0.093,P=0.133)。多元相关分析进一步证实,滑液YKL-40水平与WOMAC疼痛、肢体功能评分评分及总分呈正相关(P<0.05)。[结论]膝骨关节炎患者关节液YKL-40水平与骨关节炎严重程度的相关性,可作为一种潜在的评估膝骨关节炎症状严重性的生物标记物。[Objective] To explore the correlation between synovial fluid SF） YKL-40 and extent of knee osteoarthritis （OA） for clinical evaluation of knee OA with this new marker. [Methods] A total of 144 patients with knee OA were enrolled into this study. Symptomatic severity was determined by using Western Ontario and McMaster Universities Arthritis Index （WOMAC） scores. The radiographic severity of OA was assessed by the Kellgren-Lawrence （K-L） grading system. SF levels of YKL-40 were determined by enzyme-linked immunosorbent assay. [Results] The YKL-40 level were statistically different among the patients with different Kellgren-Lawrenee grades, associated with a sequence of Grade IV〉Grade III〉 Grade II （P〈 0.05） . Spearman correlation analysis revealed a significantly positive correlation between the YKL-40 level in SF and Kell- gren-Lawrence grading in knee OA patients （r=0.542, P〈0.001 ） . In addition, Spearman analysis showed statistically positive correlations between the YKL-40 levels in SF and WOMAC pain （r=0.517, P=0.001） , function （r=-0.380, P=0.025） and to- tal score （r=0.407, P=0.010） , however, no a correlation with WOMAC stiffness （r=0.093, P=0.133） was noted. Furthermore, multiple correlation analysis also confirmed positive correlations between SF YKL-40 levels and WOMAC pain, function and total score （P〈0.05） . [Conclusions] YKL-40 in SF is a potential biomarker for assessing the symptomatic severity of OA.

关 键 词：骨关节炎 生物标记物 人甲壳质酶-39 关节滑液 

分 类 号：R684.3[医药卫生—骨科学]