不同分期KOA患者炎症因子表达与临床症状的相关性  

The Investigation of the Inflammation Factors and the Relative Clinical Symptom in KOA

作　　者：邱高高 张继平[1] 殷慧琳 李作宏[1] 张伟强[2] QIU Gao-gao;ZHANG Ji-ping;YIN Hui-lin;LI Zuo-hong;ZHANG Wei-qiang(The Second Department of Orthopedics and Trauma,The Second People＇s Hospital of Yichang,YichangHuBei 443000;Dept.of Orthopedics,Yunnan Provincial Hospital of Traditional Chinese Hospital,Kunming Yunnan 650011,China)

机构地区：[1]宜昌市第二人民医院三峡大学第二人民医院骨外二科,湖北宜昌443000 [2]云南省中医医院骨科,云南昆明650011

出　　处：《昆明医科大学学报》2018年第10期58-62,共5页Journal of Kunming Medical University

基　　金：云南省自然科学基金资助项目(2011FZ266)

摘　　要：目的探究不同分期KOA患者在急性期炎症因子表达与症状相关性。方法 2014年7月至2017年9月在湖北省宜昌市第二人民医院骨外二科诊断为膝关节骨性关节炎(KOA)并符合纳入标准的120例患者,按照相关分期方法分为:I期组9例,Ⅱ期组50例,ⅡI期组37例,IV期组24例;入院时即予膝关节液抽取并送病理科行TNF-α、CRP、IL-6、IL-1的含量测定,同时予患膝VAS疼痛评分及膝骨性关节炎WOMAC评分。结果I、Ⅱ期TNF-α差异无统计学意义(P>0.05);与Ⅱ期比较、ⅡI期较低差异有统计学意义(P<0.05);与ⅡI期比较、IV期低差异有统计学意义(P<0.01)。I、Ⅱ期IL-1差异无统计学意义(P>0.05);与Ⅱ期比较、ⅡI期较低差异有统计学意义(P<0.05);ⅡI、IV期无差异(P>0.05)。I、Ⅱ期IL-6无差异(P>0.05);与Ⅱ期比较、ⅡI期较低(P<0.05);ⅡI、IV期差异无统计学意义(P>0.05)。I、Ⅱ期CRP差异无统计学意义(P>0.05);与Ⅱ期比较,ⅡI期明显降低差异有统计学意义(P<0.01);ⅡI、IV期差异无统计学意义(P>0.05)。VAS评分总体具有I、Ⅱ期较高,ⅡI、IV期较低的特点差异有统计学意义(P<0.01);WOMAC评分与此相反。结论炎症因子的激活和爆发在各分期KOA急性发作时具有一定的特异性,同时可能影响了相应的临床症状。Objective To investigate the expressions of relative inflammation factors in different KOA stages and their relationship with the clinical symptoms. Methods From July 2014 to September 2017 in the Second Department of Orthopedics and Trauma of the Second People＇s Hospital of Yichang, we selected 120 cases diagnosed as KOA according to certain criteria and divided them into four groups： I stage group（9 cases）,Ⅱ stage group（50 cases）, ⅡI stage group（37 cases）; IV stage group（24 cases） based on the relative staging method.When the patients were admitted, the lesion knee fluid were withdrawn and checked in the Department of Pathology. At the same time,we conducted the VAS scoring and WOMAC scoring on patients.Result TNF-a：Groups of stage I and stage Ⅱ showed no difference（P〉0.05）; compared with group of stage Ⅱ, stage ⅡI was lower（P〉0.05）; compared with group of stage ⅡI, stage IV was lower（P〈0.01）. IL-1： Groups of stage I and stage Ⅱ showed no difference（P〉0.05）;compared with group of stage Ⅱ,stage ⅡI was lower（P〉0.05）;groups of stage ⅡI and IV had no difference（P〉0.05）. IL-6： groups of stage I and Ⅱ had no difference; compared with group of stage Ⅱ, stage ⅡI was lower（P〈0.05）; groups of stage ⅡI and IV had no difference（P〉0.05）. CRP：groups of stage I and Ⅱ had no difference（P〉0.05）;compared with group of stage Ⅱ,stage ⅡI was preeminently lower（P〈0.01）;groups of stage Ⅱ and IV had no difference（P〉0.05）. VAS scoring showed that the groups of stage ⅡI and IV were lower and the groups of stage I and Ⅱ were significantly higher（P〈0.01）;WOMAC scorings were reverse. Conclusion The initiative and explosion of inflammation factor may be characteristic in different KOA acute phase and may effect the clinical symptoms.

关 键 词：膝骨性关节炎 分期 炎症因子 临床症状 

分 类 号：R684.3[医药卫生—骨科学]