膝骨关节炎患者关节滑液中IL-17水平与疾病严重程度的相关性  

The correlation between the level of IL-17 in synovial fluid and severity of the disease in patients with knee osteoarthritis

作　　者：冯方 刘英 彭毅 张晗 FENG Fang;LIU Ying;PENG Yi;ZHANG Han(Rehabilitation Department, Nanchong Central Hospital, Nanchong 637000, Sichuan, China;Southwest Petroleum University Hospital, Nanchong 637000, Sichuan, China)

机构地区：[1]南充市中心医院康复科,四川南充637000 [2]西南石油大学校医院,四川南充637000

出　　处：《西部医学》2020年第6期845-848,共4页Medical Journal of West China

基　　金：国家科技支撑计划项目(2012BAK21B01)。

摘　　要：目的探讨膝骨关节炎(KOA)患者关节滑液中IL-17的水平与疾病严重程度的相关性,为临床诊治KOA提供新思路及新方法。方法选取2017年1月~2018年12月南充市中心医院康复科收治的150例膝骨关节炎患者作为实验组,同时纳入30例健康志愿者作为对照组。实验组采用视觉模拟量表(VAS)评价膝关节的疼痛程度,采用膝关节学会评分系统(KSS)评价膝关节的功能及采用Kellgren-Lawrence(KL)分级系统评价膝关节X线严重程度,通过ELISA试验检测两组膝关节滑液中IL-17的水平。采用Spearman相关分析KOA患者关节滑液中IL-17水平与膝关节疼痛程度、膝关节功能及X线严重程度的相关性。结果实验组关节滑液中IL-17的水平明显高于对照组(P<0.05)。IL-17水平在膝关节炎KL分级之间比较,差异无统计学差异(P>0.05)。IL-17的水平与膝关节VAS评分呈正相关(r=0.914,P<0.01),IL-17的水平与KSS呈负相关(r=0.847,P<0.01),IL-17的水平与KL分级无相关性(r=0.050,P=0.545)。结论IL-17可反应膝骨关节炎患者疼痛程度及功能损伤程度,但不能反映疾病的X线严重程度。IL-17可作为一个生化指标反应膝关节炎疼痛程度及膝关节功能,临床通过减少关节滑液中IL-17,可能会减轻膝骨关节炎患者的临床症状。Objective To explore the correlation between the level of IL-17 in the synovial fluid and the severity of the disease in patients with knee osteoarthritis(KOA),and provide a new idea and method for the clinical diagnosis and treatment of KOA.Methods From January 2017 to December 2018,150 patients with knee osteoarthritis were selected as experimental group,and 30 healthy volunteers at the same time were enrolled as the control group.In the experimental group,Visual analogue scale(VAS)was used to evaluate the degree of knee pain,the knee society score(KSS)was used to evaluate the function of the knee joint,the X-ray severity of knee joint was evaluated by Kellgren-Lawrence(KL)grading system,and the level of IL-17 in synovial fluid of knee joint was measured by ELISA test.Spearman correlation analysis was used to analyze the correlation between the level of IL-17 in synovial fluid and the degree of knee joint pain,knee joint function and X-ray severity in patients with KOA.Results The level of IL-17 in synovial fluid of the experimental group was significantly higher than that of the control group(P<0.05).There was no significant difference in the level of IL-17 between the KL grades of knee arthritis(P>0.05).The level of IL-17 was positively correlated with the VAS score of knee joint(r=0.914,P<0.01),and the level of IL-17 was negatively correlated with KSS(r=0.847,P=0.01).There was no correlation between the level of IL-17 and KL grade(r=0.050,P=0.545).Conclusion IL-17 can reflect the degree of pain and functional injury in patients with knee osteoarthritis,but it cannot reflect the severity of X-ray of the disease.IL-17 can be used as a biochemical index to reflect the degree of pain and the function of knee joint in patients with knee arthritis,the clinical symptoms of patients with knee osteoarthritis may be alleviated by reducing IL-17 in synovial fluid.

关 键 词：膝关节 骨关节炎 白介素-17 关节滑液 

分 类 号：R684.3[医药卫生—骨科学]