膝骨关节炎患者血清细胞因子样蛋白1水平变化及临床意义  

Variation and Clinical Significance of Serum Cytokine-Like Protein 1 in Patients with Knee Osteoarthritis

作　　者：王汉 符林雄[1] 李儒琳 WANG Han;FU Lin-xiong;LI Ru-lin(Department of Orthopedics,Haikou Affiliated Hospital of Central South University Xiangya School of Medicine,Haikou 570208,China;Department of Orthopedics,Qionghai People’s Hospital,Qionghai 571400,China)

机构地区：[1]中南大学湘雅医学院附属海口医院骨科,海口570208 [2]琼海市人民医院骨科,海南琼海571400

出　　处：《南昌大学学报（医学版）》2022年第6期42-48,共7页Journal of Nanchang University：Medical Sciences

基　　金：海南省自然科学基金面上项目(817MS326)。

摘　　要：目的分析原发性膝骨关节炎(KOA)患者血清细胞因子样蛋白1(CYTL-1)水平变化及临床意义。方法选取2016年2月至2021年10月收治的122例KOA患者(KOA组)和165例健康志愿者(对照组)。采用酶联免疫吸附法检测2组血清CYTL-1水平以及KOA患者滑液CYTL-1水平。采用视觉模拟数字评价量表(VAS)评分及西大略湖麦克马斯特大学骨关节炎指数(WOMAC)评估KOA患者的疼痛程度及身体残疾程度。比较KOA患者血清CYTL-1水平与临床病理特征的关系。结果KOA组血清CYTL-1水平(169.10 ng·mL^(-1))低于对照组(316.11 ng·mL^(-1))(P<0.001)。血清CYTL-1水平降低是KOA发生的独立危险因素(β=-0.013,P<0.001)。血清CYTL-1水平与滑液CYTL-1水平呈正相关(r_(S)=0.521、β=0.243,P<0.001)。受试者工作特征(ROC)曲线显示,血清CYTL-1用于KOA诊断的曲线下面积(AUC)为0.834(95%CI:0.787~0.881)。Spearman秩相关分析和多元线性回归分析显示,KOA患者血清CYTL-1水平与WOMAC总评分、VAS评分呈负相关(r_(S)=-0.455、β=-0.373,r_(S)=-0.421、β=-0.218;P<0.05)。血清CYTL-1水平诊断KOA患者重度疼痛或中重度残疾的ROC曲线AUC分别为0.774(95%CI:0.685~0.863)、0.704(95%CI:0.602~0.791)。较血清CYTL-1水平≥169.10 ng·mL^(-1)患者,<169.10 ng·mL^(-1)患者的Kellgren-Lawrence分级为4级(78.79%比21.21%)、软骨缺损评分≥22.67分(70.18%比29.82%)以及站起-走计时测试秒数≥5.95 s(60.66%比39.34%)的占比均更高(P<0.05)。结论KOA患者血清CYTL-1水平降低与疾病发生和进展密切相关,有望成为KOA诊断和治疗的候选分子。Objective To analyze the variation and clinical significance of serum cytokine-like protein 1(CYTL-1)in patients with primary knee osteoarthritis(KOA).Methods A total of 122 KOA patients admitted from February 2016 to October 2021 were selected as the subjects,and 165 healthy volunteers as the control group.Serum CYTL-1 levels in both groups and synovial CYTL-1 levels in KOA patients were detected by enzyme-linked immunosorbent assay.The degree of pain and disability were assessed by Visual Analogue Scale(VAS)and the Western Ontario and McMaster Universities Arthritis Index(WOMAC).In addition,the relationship between serum CYTL-1 level and clinicopathological features was analyzed in KOA patients.Results The serum CYTL-1 level in the KOA group(169.10 ng·mL^(-1))was lower than that in the control group(316.11 ng·mL^(-1))(P<0.001).The decrease in serum CYTL-1 level was an independent risk factor for the occurrence of KOA(β=-0.013,P<0.001).There was a positive correlation between serum and synovial CYTL-1 levels in KOA patients(r_(S)=0.521、β=0.243,P<0.001).The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of serum CYTL-1 was 0.834(95%CI:0.787-0.881)for the diagnosis of KOA.Spearman rank correlation analysis and multiple linear regression analysis showed that serum CYTL-1 level in KOA patients was negatively correlated with the total WOMAC score and VAS score(r_(S)=-0.455 and-0.421,respectively;β=-0.373 and-0.218,respectively;P<0.05).The AUC of serum CYTL-1 level was 0.774(95%CI:0.685-0.863)for the diagnosis of severe pain,and 0.704(95%CI:0.602-0.791)for the diagnosis of moderate-severe disability in KOA patients.Compared to the patients with serum CTTL^(-1)≥169.10 ng·mL^(-1),the patients with serum CYTL-1<169.10 ng·mL^(-1) had higher incidences of Kellgren-Lawrence grade 4(78.79%vs 21.21%),cartilage defect score≥22.67(70.18%vs 29.82%),and Time Up and Go test seconds≥5.95 s(60.66%vs 39.34%)(P<0.05).Conclusion The decrease in serum CYTL-1 level is closely related t

关 键 词：膝骨关节炎 细胞因子样蛋白1 西大略湖麦克马斯特大学骨关节炎指数 视觉模拟数字评价量表 疼痛 残疾 

分 类 号：R684.3[医药卫生—骨科学]