膝关节骨性关节炎患者血清GPC3和CCL3水平及其与病情严重程度的相关性分析  

Analysis of serum GPC3 and CCL3 levels and their correlation with disease severity in patients with knee osteoarthritis

作　　者：闫梦洋 张勇 董福生 郭新响 赵钰 解俊婷 YAN Mengyang;ZHANG Yong;DONG Fusheng;GUO Xinxiang;ZHAO Yu;XIE Junting(Department of Hand and Foot Surgery,the Second Hospital of Qinhuangdao,Qinhuangdao,Hebei 066600,China;Department of Trauma and Joint,the Second Hospital of Qinhuangdao,Qinhuangdao,Hebei 066600,China;Department of Anesthesiology,the Second Hospital of Qinhuangdao,Qinhuangdao,Hebei 066600,China;Sports Medicine Center,Rehabilitation Hospital Affiliated to Capital Medical University,Beijing 100010,China)

机构地区：[1]河北省秦皇岛市第二医院手足外科,河北秦皇岛066600 [2]河北省秦皇岛市第二医院创伤关节科,河北秦皇岛066600 [3]河北省秦皇岛市第二医院麻醉科,河北秦皇岛066600 [4]首都医科大学附属康复医院运动医学中心,北京100010

出　　处：《检验医学与临床》2025年第5期625-629,共5页Laboratory Medicine and Clinic

基　　金：河北省秦皇岛市市级科学技术研究与发展计划自筹经费项目(202301A230)。

摘　　要：目的探讨膝关节骨性关节炎(KOA)患者血清磷脂酰肌醇蛋白聚糖-3(GPC3)和趋化因子配体3(CCL3)水平及其与病情严重程度的相关性。方法选取2022年7月至2023年7月河北省秦皇岛市第二医院收治的118例KOA患者作为研究组,根据Kellgren-Lawrence(K-L)分级系统将研究组又分为Ⅱ级组、Ⅲ级组和Ⅳ级组。另选取同期河北省秦皇岛市第二医院100例健康体检者作为对照组。采用酶联免疫吸附试验检测研究组和对照组血清GPC3、CCL3水平;采用Spearman相关分析KOA患者血清GPC3、CCL3水平与K-L分级的相关性;采用多因素Logistic回归分析KOA患者病情严重程度的影响因素。采用受试者工作特征(ROC)曲线分析血清GPC3、CCL3对KOA病情严重程度的诊断价值。结果研究组血清GPC3水平低于对照组,CCL3水平高于对照组,差异均有统计学意义(t=-8.067、5.260,P<0.05)。Ⅱ级组、Ⅲ级组和Ⅳ级组血清GPC3、CCL3水平比较,差异均有统计学意义(F=56.530、37.977,P<0.05)。Spearman相关分析结果显示,KOA患者血清GPC3水平与K-L分级呈负相关(r=-0.651,P<0.05);KOA患者CCL3水平与K-L分级呈正相关(r=0.519,P<0.05)。Ⅱ级组、Ⅲ级组和Ⅳ级组病程比较,差异有统计学意义(F=86.951,P<0.05)。多因素Logistic回归分析结果显示,血清CCL3水平升高、病程长是KOA患者病情严重的独立危险因素(P<0.05),GPC3水平升高是KOA患者病情严重的独立保护因素(P<0.05)。ROC曲线分析结果显示,血清GPC3、CCL3及二者联合检测诊断KOA病情严重程度的曲线下面积(AUC)分别为0.863、0.891、0.961,二者联合检测诊断KOA病情严重程度的AUC大于GPC3、CCL3单独检测的AUC,差异均有统计学意义(Z=2.130、2.251,P=0.033、0.002)。结论KOA患者血清GPC3水平降低,CCL3水平升高,二者水平与病情严重程度均密切相关,且二者联合检测对KOA的病情严重程度具有较高的诊断价值。Objective To investigate the serum levels of glypican-3(GPC3)and chemokine ligand 3(CCL3)in patients with knee osteoarthritis(KOA)and their correlation with disease severity.Methods A total of 118 KOA patients admitted to the Second Hospital of Qinhuangdao in Hebei province from July 2022 to July 2023 were selected as the study group.According to the Kellgren-Lawrence(K-L)grading system,the study group was divided into gradeⅡgroup,gradeⅢgroup and gradeⅣgroup.In addition,100 healthy subjects in the Second Hospital of Qinhuangdao in Hebei province during the same period were selected as the control group.The serum levels of GPC3 and CCL3 in the study group and the control group were detected by enzyme-linked immunosorbent assay.Spearman correlation analysis was used to analyze the correlation between serum GPC3,CCL3 levels and K-L grade in KOA patients.Multivariate Logistic regression was used to analyze the influencing factors of the severity of KOA patients.The receiver operating characteristic(ROC)curve was used to analyse the diagnostic value of serum GPC3 and CCL3 for the severity of KOA.Results The level of serum GPC3 in the study group was lower than that in the control group,and the level of CCL3 was higher than that in the control group,and the differences were statistically significant(t=-8.067,5.260,P<0.05).There were significant differences in serum GPC3 and CCL3 levels among gradeⅡgroup,gradeⅢgroup and gradeⅣgroup(F=56.530,37.977,P<0.05).Spearman correlation analysis showed that the level of serum GPC3 was negatively correlated with K-L grade(r=-0.651,P<0.05)in KOA patients.The level of CCL3 was positively correlated with K-L grade(r=0.519,P<0.05).There were statistically significant differences in the course of disease among gradeⅡgroup,gradeⅢgroup and gradeⅣgroup(F=86.951,P<0.05).Multivariate Logistic regression analysis showed that increased serum CCL3 level and long course of disease were independent risk factors for severe disease in KOA patients(P<0.05),and increased GPC3 level

关 键 词：膝关节骨性关节炎 磷脂酰肌醇蛋白聚糖-3 趋化因子配体3 病情严重程度 相关性 

分 类 号：R684.3[医药卫生—骨科学] R446.1[医药卫生—外科学]