α-促黑色素细胞刺激激素与原发性膝骨关节炎进展的相关性研究  

Correlations ofα-melanocyte stimulating hormone levels in serum and synovial fluid with progression of primary knee osteoarthritis

作　　者：刘伟乐[1] 钟浩博[1] 王胤 郑少伟[1] 黎旭 谢福杰 孙春汉[1] Liu Weile;Zhong Haobo;Wang Yin;Zheng Shaowei;Li Xu;Xie Fujie;Sun Chunhan(Department of Orthopedics,The First Hospital of Huizhou,Huizhou 516000,China;Guangdong Medical University,Zhanjiang 524023,Guangdong,China)

机构地区：[1]惠州市第一人民医院骨科,516000 [2]广东医科大学,广东省湛江市524023

出　　处：《中华创伤骨科杂志》2021年第8期711-716,共6页Chinese Journal of Orthopaedic Trauma

基　　金：2015惠州市第一人民医院科研培育与创新基金项目。

摘　　要：目的探讨原发性膝骨关节炎(KOA)患者血清、关节滑液α-促黑色素细胞刺激激素(α-MSH)水平与KOA病变程度的相关性。方法回顾性分析2018年10月到2019年10月在惠州市第一人民医院骨科诊断为原发性KOA的96例患者资料(设为KOA组)。影像学严重程度由Kellgren-Lawrence(K-L)分级确定。采用酶联免疫吸附试验(ELISA)测量血清及关节骨液中α-MSH水平,并测定关节滑液白细胞介素1β(IL-1β)和基质金属蛋白酶-3(MMP-3)的水平。同时选取年龄和性别匹配的髌骨脱位患者64例作为对照组。应用数字疼痛量表(NPS)和修订版牛津膝关节评分(OKS)评估症状严重程度。采用受试者工作特征曲线(ROC)分析比较α-MSH、IL-1β和MMP-3用于K-L等级的诊断价值。结果两组患者年龄、性别、体重指数比较差异均无统计学意义(P>0.05),具有可比性。KOA组患者关节滑液中的α-MSH水平显著低于对照组[(16.9±3.8)pg/mL vs.(18.8±2.7 pg/mL)],差异有统计学意义(P<0.001)。KOA组患者血清α-MSH水平与对照组比较[(24.9±1.8)pg/mL vs.(24.8±1.7)pg/mL],差异无统计学意义(P>0.05)。关节滑液α-MSH水平与K-L分级、NPS评分均呈负相关性(r=-0.382,P<0.001;r=-0.382,P<0.001),与OKS评分呈正相关(r=0.339,P<0.001)。进一步分析表明,关节滑液α-MSH水平与关节滑液IL-1β、MMP-3的表达均呈负相关(r=-0.483,P<0.001;r=-0.336,P<0.001)。结论血清α-MSH水平与KOA进展无相关性,而关节滑液α-MSH与KOA的进展呈负相关。关节滑液中α-MSH的表达水平与关节软骨破坏严重程度相关,可作为一种潜在的评估KOA症状严重程度的生物标记物。Objective To explore the correlations ofα-melanocyte stimulating hormone(α-MSH)levels in serum and synovial fluid with progression of primary knee osteoarthritis(KOA).Methods A retrospective analysis was conducted of the 96 patients who had been diagnosed as primary KOA at Department of Orthopedics,The First Hospital of Huizhou from October 2018 to October 2019.Radiographic severity of KOA was determined by Kellgren-Lawrence(K-L)grades;α-MSH levels were measured by enzyme-linked immunosorbent assay(ELISA).Levels of pro-inflammatory cytokine interleukin-1β(IL-1β)and matrix metalloproteinase-3(MMP-3)were also detected.Another 64 patients with patellar dislocation,matched in age and gender,were enrolled as controls.The Numeric Pain Scale(NPS)and revised Oxford Knee Score(OKS)were employed to evaluate their symptomatic severity.Receiver operating characteristics(ROC)curve was used to compareα-MSH,IL-1βand MMP-3 with regard to their diagnostic values in the K-L grading.Results There were no statistically significant difference in age,gender and body mass index between the 2 groups,showing they were comparable(P>0.05).Theα-MSH levels in synovial fluid were significantly lower in the KOA patients than in the controls[(16.9±3.8)pg/mL versus(18.8±2.7)pg/mL](P<0.001);there were no significant differences between the KOA patients and the controls in the serumα-MSH levels[(24.9±1.8)pg/mL versus(24.8±1.7)pg/mL](P>0.05).Theα-MSH levels in synovial fluid were negatively correlated with K-L grades(r=-0.382,P<0.001)and negatively correlated with NPS(r=-0.382,P<0.001)but positively correlated with OKS(r=0.339,P<0.001).Moreover,theα-MSH levels in synovial fluid were negatively correlated with the IL-1βlevels in synovial fluid(r=-0.483,P<0.001)and with the MMP-3 levels in synovial fluid(r=-0.336,P<0.001).Conclusions The level of serumα-MSH may not be correlated with the progression of KOA but the synovial fluidα-MSH is negatively correlated with the progression of KOA.Therefore,the expression level ofα-MSH in join

关 键 词：骨关节炎 膝 血清 滑液 α-促黑色素细胞刺激激素 

分 类 号：R684.3[医药卫生—骨科学]