胫骨内侧高位截骨对单纯内侧间室膝关节骨关节炎患者滑液中炎性因子及软骨降解因子的影响  

Effect of High Medial Tibial Osteotomy on Inflammatory Factors of Synovial Fluid and Cartilage Degrading Factors of Simple Medial Compartment from Knee Osteoarthritis Patients

作　　者：杨勇 赵良虎 黄金 陈超前 罗建军 YANG Yong;ZHAO Lianghu;HUANG Jin;CHEN Chaoqian;LUO Jianjun(Department of Knee Joint,Affiliated Hospital of Panzhihua University,Panzhihua 617000,Sichuan China)

机构地区：[1]攀枝花学院附属医院膝关节科,四川攀枝花617000

出　　处：《中国中医骨伤科杂志》2021年第4期73-76,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨胫骨内侧高位截骨术治疗单纯内侧间室膝关节骨性关节炎(KOA)后患者滑液中炎性因子及软骨降解因子的影响。方法:收集2017年1月至2019年6月因单纯内侧间室KOA于本院行胫骨内侧高位截骨术的患者30例,收集患者治疗前及治疗后3、6及12个月膝关节WOMCA评分及视觉模拟疼痛评分(VAS),收集患者术前及术后3、6及12个月膝关节滑液,使用ELISA法检测滑液中炎性因子(IL-1β、IL-6、TNF-α)和软骨降解因子(MMP3、MMP9、ADAMTS4)的表达变化。结果:所有患者均获得随访,术后患者伤口均愈合良好,截骨线均骨性愈合,无血管神经损伤等并发症发生。术后3、6及12个月患者VAS及WOMAC评分均显著低于术前(P<0.05)。ELISA结果显示,与术前滑液中炎性因子和软骨降解因子的表达量相比,术后3、6及12个月患者炎性因子及软骨降解因子表达水平显著降低(P<0.05)。结论:胫骨内侧高位截骨术可以有效改善单纯内侧间室KOA患者功能评分,缓解患者疼痛,并可降低滑液中炎性因子及软骨降解因子的表达水平,从而延缓软骨损伤。Objective:To investigate the effects of high medial tibial osteotomy on inflammatory factors of synovial fluid and cartilage degrading factors of simple medial compartment from knee osteoarthritis(KOA) patients.Methods:A total of 30 patients who underwent high medial tibial osteotomy in our hospital for simple medial compartment KOA from January 2017 to June 2019 were collected.The WOMCA,VAS was collected before treatment and 3,6 and 12 months after treatment.Synovial fluid of patients was collected before treatment and 3,6 and 12 months after treatment, and then use ELISA to detect inflammatory factors(IL-1β,IL-6,TNF-α) and cartilage degradation factors(MMP3,MMP9,ADAMTS4) expression.Results:All patients healed well without complications such as vascular or nerve injury.There were followed up for 12 momths.The VAS and WOMAC scores of patients at 3,6 and 12 months after operation were significantly lower than those before operation(P<0.05).ELISA results showed that compared with the expression levels of inflammatory factors and cartilage degrading factors in synovial fluid before surgery, the expression levels of inflammatory factors and cartilage-degrading factors at 3,6 and 12 months after operation were significantly reduced(P<0.05).Conclusion:High medial tibial osteotomy can effectively improve the functional score and relieve pain in the patients with simple medial compartment KOA,and also effectively reduce the expression levels of inflammatory factors and cartilage degradation factors in synovial fluid and delay the cartilage damage.

关 键 词：胫骨内侧高位截骨术 膝关节骨性关节炎 炎性因子 软骨降解因子 

分 类 号：R684.3[医药卫生—骨科学]