伴骨髓水肿的老年膝骨关节炎与护骨因子、dickkopf-1、硬骨素的相关性研究  

Study on the correlation of elderly knee osteoarthritis with bone marrow edema and osteoprotegerin,dickkopf-1,sclerostin

作　　者：吴晓惠[1] 王翠平[1] 李敏[1] 秦雪飞[1] 吴佳[1] 余文景[1] 沙湖[1] 王磊 梁翼[1] WU Xiaohui;WANG Cuiping;LI Min;QIN Xuefei;WU Jia;YU Wenjing;SHA Hu;WANG Lei;LIANG Yi(Department of Rheumatology,Sichuan Province Orthopedic Hospital,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川省骨科医院风湿骨关节病科,成都610041

出　　处：《华西医学》2021年第11期1545-1549,共5页West China Medical Journal

基　　金：四川省干部保健科研课题(川干研2016-605);四川省中医药管理局资助项目(2018LC025)。

摘　　要：目的探讨伴有骨髓水肿的老年膝骨关节炎与护骨因子、dickkopf-1(DKK-1)和硬骨素的相关性。方法选取2017年9月-2018年12月四川省骨科医院的老年膝骨关节炎患者100例,分为骨髓水肿组(50例)和非骨髓水肿组(50例),分别收集其基本资料、西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster University Osteoarthritis Index,WOMAC)评分和视觉模拟评分法得分,检测其血清护骨因子、DKK-1、硬骨素、C反应蛋白、红细胞沉降率,并比较两组之间的差异,探讨其检测指标与骨髓水肿及其临床指标的相关性。结果两组患者的年龄、性别、病程、C反应蛋白和红细胞沉降率差异无统计学意义(P>0.05)。骨髓水肿组患者的WOMAC评分[(76.1±5.4)vs.(67.5±6.6)分]、视觉模拟评分法得分[(8.4±1.1)vs.(5.5±0.9)分]、滑膜炎比例(84.0%vs.52.0%)、护骨因子[(1.3±1.1)vs.(0.6±0.5)μg/L]、DKK-1[(18.4±16.9)vs.(6.9±6.0)μg/L]和硬骨素[(147.3±119.4)vs.(99.7±70.7)pg/mL]均高于非骨髓水肿组(P<0.05)。骨髓水肿组患者的骨髓水肿容积积分和程度积分与血清护骨因子相关性无统计学意义(P>0.05),与血清DKK-1(容积积分rs=0.464,P=0.001;程度积分rs=0.379,P=0.007)、硬骨素(容积积分rs=0.316,P=0.025;程度积分rs=0.461,P=0.003)呈正相关。结论伴有骨髓水肿的老年膝骨关节炎患者局部骨代谢指标护骨因子、DKK-1、硬骨素上调,尤以DKK-1、硬骨素与骨髓水肿的严重程度相关。Objective To investigate the correlation of elderly knee osteoarthritis with bone marrow edema and osteoprotegerin,DKK-1(dickkopf-1),sclerostin.Methods A total of 100 elderly patients with knee osteoarthritis in Sichuan Province Orthopedic Hospital from September 2017 to December 2018 were selected and divided into bone marrow edema group(50 cases)and non-bone marrow edema group(50 cases).The patients’basic data,Western Ontario and McMaster University Osteoarthritis Index(WOMAC)scores and Visual Analogue Scale scores were collected.The patients’serum osteoprotegerin,DKK-1,sclerostin,C-reactive protein,and erythrocyte sedimentation rate were tested,and the differences between the two groups were compared.The correlation of the detection indicators and bone marrow edema and its clinical indicators was explored.Results There was no significant difference in age,gender,course of disease,C-reactive protein and erythrocyte sedimentation rate between the two groups(P>0.05).WOMAC scores(76.1±5.4 vs.67.5±6.6),Visual Analogue Scale scores(8.4±1.1 vs.5.5±0.9),proportion of synovitis(84.0%vs.52.0%),osteoprotegerin[(1.3±1.1)vs.(0.6±0.5)μg/L],DKK-1[(18.4±16.9)vs.(6.9±6.0)μg/L]and sclerostin[(147.3±119.4)vs.(99.7±70.7)pg/mL]in the bone marrow edema group were higher than those in the non-bone marrow edema group(P<0.05).There was no statistically significant correlation of the bone marrow edema volume score and degree score and serum osteoprotegerin of patients in the bone marrow edema group(P>0.05).The bone marrow edema volume score and degree score of patients in the bone marrow edema group were positively correlated with serum DKK-1(volume score rs=0.464,P=0.001;degree score rs=0.379,P=0.007)and sclerostin(volume score rs=0.316,P=0.025;degree score rs=0.461,P=0.003).Conclusion In elderly patients with knee osteoarthritis and bone marrow edema,the local bone metabolism indicators of osteoprotegerin,DKK-1 and sclerostin are up-regulated,especially DKK-1 and sclerostin are related to the severity of bone marrow e

关 键 词：护骨因子 硬骨素 骨髓水肿 膝骨关节炎 

分 类 号：R684.3[医药卫生—骨科学]