膝骨关节炎患者膝关节液中TNF-α、ILs、MMPs、YKL-40的表达  

Expression of TNF-α,ILs,MMPs,and YKL-40 in the knee joint fluid of patients with knee osteoarthritis

作　　者：赵灵芝 梁勤[1] 鲁彦[2] 张锐[3] 杨巧林[1] 付慧 柳海平[3] ZHAO Lingzhi;LIANG Qin;LU Yan;ZHANG Rui;YANG Qiaolin;FU Hui;LIU Haiping(Laboratory Medicine Center,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China;Laboratory Medicine Center,Gansu Provincial Hospital,Lanzhou 730000,China;Department of Orthopedic Joint,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China)

机构地区：[1]甘肃省中医院检验科,甘肃兰州730050 [2]甘肃省人民医院检验科,甘肃兰州730000 [3]甘肃省中医院关节骨科,甘肃兰州730050

出　　处：《中国骨质疏松杂志》2024年第11期1581-1586,共6页Chinese Journal of Osteoporosis

基　　金：甘肃省自然科学基金(21JR7RA587)。

摘　　要：目的研究膝骨关节炎(knee osteoarthritis,KOA)患者膝关节液中肿瘤坏死因子-α(TNF-α)、白介素(ILs)、基质金属蛋白酶(MMPs)、人甲壳质酶-40(YKL-40)的表达水平,及其与膝关节影像学Kellgren-Lawrence(K~L)分级之间的关系。方法选取100例行膝关节置换术的KOA患者,根据K~L标准将其分为KL~3级和KL~4级两组。在术前抽取患者的膝关节液,分别采用流式细胞小球微阵列术和ELISA方法检测膝关节液中TNF-α、IL-1β、IL-6、IL-8、IL-15和MMP-3、MMP-9、MMP-13、YKL-40的表达水平。采用两组间比较和单、多因素Logistic回归筛选KL~4的独立影响因素。选择Spearman法分析上述分子与K~L分级之间的相关性。结果100名KOA患者中男性25名,女性75名,平均年龄64.32岁,平均病程为8.98年。KL~3级55人、KL~4级45人。TNF-α、IL-1β、MMP-13、YKL-40在KL~3中表达较高,IL-6、IL-8、IL-15、MMP-3、MMP-9在KL~4中表达较高。IL-15、MMP-9在两组间的差异具有统计学意义(P<0.05)。单、多因素二元Logistic回归结果显示,IL-15[优势比(OR)=1.575,95%可信区间(95%CI):1.286~1.929,P<0.001]和MMP-9(OR=1.032,95%CI:1.008~1.056,P=0.01)是KL~4的独立危险因素。IL-15(r=0.220,P<0.05)、MMP-9(r=0.297,P<0.05)分别与K~L分级之间存在显著的正相关关系。结论KOA患者膝关节液中IL-15、MMP-9在KL~4级患者中高表达。IL-15和MMP-9是KL~4的独立危险因素,其水平与K~L分级之间存在正相关关系。IL-15与MMP-9有望为临床对该疾病的进展和评估提供参考。Objective To investigate the expression levels of tumor necrosis factorα(TNF-α),interleukins(ILs),matrix metalloproteinases(MMPs),and chitinase(YKL-40)in the knee joint fluid of patients with knee osteoarthritis(KOA),and their correlations with Kellgren-Lawrence(K-L)grade of knee imaging.Methods A total of 100 KOA patients undergoing the knee arthroplasty were enrolled and their knee joint fluid was extracted before the joint surgery.The expression levels of TNF-α,IL-1β,IL-6,IL-8,IL-15,and MMP-3,MMP-9,MMP-13,YKL-40 in the knee joint fluid were detected using cytometric bead array and ELISA,respectively.Patients were grouped according to the K-L scores.The independent influencing factors of KL-4 were determined by comparison between the two groups and binary logistic regression.Spearman method was used to analyze the correlations between the above molecules and K-L grades.Results Among 100 patients with KOA,25 were males and 75 were females.The mean age was 64.32 years and the mean course of the disease was 8.98 years.There were 55 with KL-3 grade and 45 with KL-4 grade.TNF-α,IL-1β,MMP-13,and YKL-40 were highly expressed in KL-3,while IL-6,IL-8,IL-15,MMP-3,and MMP-9 were highly expressed in KL-4.IL-15 and MMP-9 were significantly different between the two groups(P<0.05).The result of univariate and multivariate logistic regression showed that IL-15[odds ratio(OR)=1.575,95%confidence interval(CI):1.286-1.929;P<0.001]and MMP-9(OR=1.032,95%CI:1.008-1.056,P=0.01)were independent risk factors for the KL-4.IL-15(r=0.220,P<0.05)and MMP-9(r=0.297,P<0.05)were positively correlated with K-L grades.Conclusion The expressions of IL-15 and MMP-9 in the knee joint fluid of KOA patients are higher than that of KL-4 patients.IL-15 and MMP-9 are independent risk factors for the KL-4.There is a positive correlation between IL-15 and MMP-9 levels and the progression of radiographic K-L grades.IL-15 and MMP-9 may provide references for clinical evaluation and progression of this disease.

关 键 词：膝骨关节炎 炎性细胞因子 基质金属酶 

分 类 号：R446.19[医药卫生—诊断学]