微创针刀镜治疗膝关节慢性痛风性关节炎的疗效观察  

Exploring on curative effect of minimally invasive acupotomicroscope in treatment of chronic gouty arthritis of knee osteoarthritis

作　　者：谭立辉 毛敦 卫荣 陈玉琪 董建建 金晨凯 惠奕 周文明[1] TAN Lihui;MAO Dun;WEI Rong;CHEN Yuqi;DONG Jianjian;JIN Chenkai;HUI Yi;ZHOU Wenming(Department of Rheumatology and Immunology,the People's Hospital of Suzhou New District,Suzhou Jiangsu 215129,China;Department of Orthopedics,Community Health Service Center of Suzhou Science and Technology City,Suzhou Jiangsu 215129,China)

机构地区：[1]苏州高新区人民医院风湿免疫科,江苏苏州215129 [2]苏州科技城社区卫生服务中心骨科,江苏苏州215129

出　　处：《新疆医科大学学报》2025年第2期229-234,共6页Journal of Xinjiang Medical University

基　　金：国家自然科学基金项目(81060322)。

摘　　要：目的探讨微创针刀镜治疗膝关节慢性痛风性关节炎的临床疗效。方法回顾性分析2020年12月至2023年12月收治并采用微创针刀镜手术的62例膝关节慢性痛风性关节炎患者,比较术前、术后1个月和术后6个月患者红细胞沉降率(Erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein)、白细胞介素-1β(Interleukin-1β,IL-1β)、IL-6、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、NOD样受体蛋白3(NOD-like receptor pyrin domain containing 3,NLRP3)、Toll样受体蛋白4(Toll-like receptor 4,TLR4)、细胞核因子-κB(Nuclear factor-κB,NF-κB)、血尿酸水平、膝关节晶体含量及膝关节视觉模拟评分(Visual analogue scale,VAS)和Lysholm评分。结果与术前相比,微创针刀镜治疗后患者ESR、CRP、IL-1β、IL-6、TNF-α、TLR4、NF-κB、血尿酸水平以及VAS评分降低(P<0.05),膝关节晶体含量显著减少(P<0.01),膝关节Lysholm评分提高(P<0.05);与术后1个月相比,术后6个月患者膝关节功能进一步改善,但ESR差异无统计学意义(P>0.05)。互作网络结果显示,术后患者痛风标志物NLRP3水平显著降低,且其水平主要受cytokine和TNF-α/NF-κB信号通路的调控。结论对膝关节慢性痛风性关节炎患者采用微创针刀镜治疗有助于缓解关节疼痛和炎症反应,有效改善关节功能。Objective The investigation of clinical efficacy of minimally invasive needle knife microscopy therapy for chronic gouty knee arthritis.Methods A retrospective analysis was conducted on 62 patients with chronic gouty knee arthritis who were admitted to underwent minimally invasive needle knife microscopy from December 2020 to December 2023.The erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),NOD-like receptor pyrin domain containing 3(NLRP3),toll-like receptor 4(TLR4),nuclear factor-κB(NF-κB),blood uric acid level,knee joint crystal content,knee joint visual analogue scale(VAS)score and Lysholm score were compared before and after the surgery at 1 month and 6 month,respectively.Results Compared with the pre-surgery condition,the ESR,CRP,IL-1β,IL-6,TNF-α,TLR4,NF-κB,blood uric acid level and VAS score of the patients decreased after minimally invasive needle-knife endoscopy treatment(P<0.05),the knee joint crystal content was significantly reduced(P<0.01),and the knee joint Lysholm score was improved(P<0.05).Moreover,the improvement level at 6 months after surgery was higher than that at 1 month after the surgery,and there was no significant difference in ESR(P>0.05).The results of interaction network showed that the level of gout marker NLRP3 decreased significantly after operation,and its level was mainly regulated by cytokine and TNF-α/NF-κB signaling pathway.Conclusion Minimally invasive needle knife microscopy therapy for the patients with chronic gouty knee arthritis is helpful in relieving joint inflammation and pain and effectively improving joint function.

关 键 词：痛风性关节炎 微创针刀镜 中医 NLRP3 

分 类 号：R678.4[医药卫生—外科学]