创伤性膝骨关节炎患者血清基质金属蛋白酶-13、基质金属蛋白酶组织抑制因子-1、骨硬化蛋白水平与预后的相关性  

Correlation between Serum Levels of Matrix Metalloproteinase-13,Tissue Inhibitor of Matrix Metalloproteinase-1,Osteosclerosis Protein and Prognosis in Patients with Traumatic Knee Osteoarthritis

作　　者：李健伟[1] 胡锋[1] 殷琴 廉凯 华寒冰 LI Jianwei;HU Feng;YIN Qin;LIAN Kai;HUA Hanbing(Hand and Foot Microsurgery,Puren Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430080,China;Emergency Department of General Hospital of the YUangtze River Shipping,Wuhan 430015,China;Department of Orthopedics,Affiliated Hospital of Hubei University of Arts and Sciences(Xiangyang Central Hospital),Xiangyang 441021,Hubei China)

机构地区：[1]武汉科技大学附属普仁医院手足显微外科,武汉430080 [2]长江航运总医院急诊科 [3]湖北文理学院附属医院(襄阳市中心医院)骨科

出　　处：《中国中医骨伤科杂志》2023年第8期43-47,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：湖北省卫生计生委科研项目(JX6B36)。

摘　　要：目的:探讨血清基质金属蛋白酶-13(MMP-13)、基质金属蛋白酶组织抑制因子-1(TIMP-1)、骨硬化蛋白(SOST)水平联合检测在创伤性膝骨关节炎(KOA)患者预后中的预测价值。方法:选取2019年6月至2021年6月住院治疗的105例创伤性膝骨关节炎患者进行研究。根据Lysholm膝关节功能评分将患者分为预后良好组(34例)和预后不良组(71例)。采用酶联免疫吸附法测定血清MMP-13、TIMP-l及SOST水平;Pearson法分析血清MMP-13、TIMP-l、SOST表达水平与美国膝关节协会评分(KSS)和美国特种外科医院膝关节评分(HSS)的相关性;多因素Logistic回归分析影响创伤性膝骨关节炎患者预后的相关因素;受试者工作特征(ROC)曲线分析血清MMP-13、TIMP-l和SOST水平对创伤性膝骨关节炎患者预后状态的预测效能。结果:预后不良组患者血清MMP-13、TIMP-l表达水平均高于预后良好组,而SOST表达水平低于预后良好组,差异有统计学意义(P<0.05);血清MMP-13、TIMP-l水平与KSS评分、HSS评分均呈负相关,差异有统计学意义(P<0.05);SOST与KSS评分、HSS评分呈正相关,差异有统计学意义(P<0.05);预后不良组K-L分级为Ⅲ级+Ⅳ级的患者所占比例高于预后良好组,差异有统计学意义(P<0.05);MMP-13、TIMP-l及Kellgren-Lawrence(K-L)分级均为创伤性膝骨关节炎患者预后不良的危险因素,SOST为保护因素,差异有统计学意义(P<0.05);血清MMP-13、TIMP-l、SOST预测创伤性膝骨关节炎患者预后状态的曲线下面积(AUC)分别为0.855,0.891及0.941,而三者联合检测的曲线下面积为0.993,均高于血清MMP-13、TIMP-l、SOST单独检测(Z三者联合-MMP-13=2.403,Z三者联合-TIMP-l=2.311,Z三者联合-SOST=1.962,P=0.038,0.026,0.022)。结论:血清MMP-13、TIMP-l、SOST水平与创伤性膝骨关节炎患者预后状态具有显著的相关性,三者联合检测对患者的预后状态具有较好的预测效能。Objective:To investigate the prognostic value of the combined detection of serum matrix metalloproteinase-13(MMP-13),tissue inhibitor of matrix metalloproteinase-1(TIMP-1),and sclerostin(SOST)in patients with traumatic knee osteoarthritis(KOA).Methods:A total of 105 patients with traumatic KOA,admitted from June 2019 to June 2021,were included in this study.Based on the Lysholm knee function score,the patients were divided into two groups:34 patients in the good prognosis group and 71 patients in the poor prognosis group.Enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of serum MMP-13,TIMP-1,and SOST.Pearson's correlation analysis was performed to assess the correlation between the expression levels of serum MMP-13,TIMP-1,SOST,and the scores of knee society score(KSS)and hospital for special surgery(HSS).Multivariate logistic regression analysis was conducted to identify the factors affecting the prognosis of patients with traumatic KOA.The predictive efficacy of serum MMP-13,TIMP-1,and SOST levels for the prognosis of patients with traumatic KOA was analyzed using receiver operating characteristic(ROC)curve analysis.Results:The expression levels of serum MMP-13 and TIMP-1 were higher in patients with poor prognosis compared to those with good prognosis,while the expression level of SOST was lower in patients with poor prognosis(P<0.05).Serum MMP-13 and TIMP-1 levels were negatively correlated with KSS score and HSS score(P<0.05),whereas SOST showed a positive correlation with KSS score and HSS score(P<0.05).The proportion of patients with kellgren-lawrence(K-L)gradeⅢ+Ⅳwas higher in the poor prognosis group compared to the good prognosis group(P<0.05).MMP-13,TIMP-1,and K-L grade were identified as risk factors for poor prognosis in patients with traumatic KOA,while SOST was identified as a protective factor(P<0.05).The area under the curve(AUC)of serum MMP-13,TIMP-1,and SOST for predicting the prognosis of patients with traumatic KOA was 0.855,0.891,and 0.941,respectively.The AUC of the

关 键 词：基质金属蛋白酶-13 基质金属蛋白酶组织抑制因子-1 骨硬化蛋白 创伤性膝骨关节炎 

分 类 号：R684.3[医药卫生—骨科学]