胫骨高位截骨术治疗单纯内侧间室膝骨关节炎术后炎性细胞因子水平变化研究

发布时间：2018-01-20 16:08

本文关键词： 胫骨高位截骨术骨关节炎膝关节 IL-β IL- IL-　出处：《中国修复重建外科杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨胫骨高位截骨术(hight tibial osteotomy,HTO)治疗单纯内侧间室膝骨关节炎(osteoarthritis,OA)后患者血浆和关节滑液中IL-1β、IL-6、IL-17水平变化。方法以2011年1月-2014年6月因单纯内侧间室膝关节OA行HTO治疗的26例患者作为研究对象(试验组),以30例膝关节正常的自愿者作为正常对照(对照组)。两组研究对象性别、年龄、体质量指数比较差异均无统计学意义(P0.05)。试验组术后复查X线片,记录截骨愈合时间,测量股胫角,评估下肢力线;采用膝关节学会评分系统(KSS)评价膝关节功能,疼痛视觉模拟评分(VAS)评价膝关节疼痛程度。术前及术后6、12、18个月抽取肘部静脉血以及患侧膝关节滑液,采用ELISA检测试剂盒测量血浆及关节滑液IL-1β、IL-6、IL-17含量,对照组抽取肘部静脉血进行相应检测并比较。结果试验组患者术后切口均Ⅰ期愈合。术后均获随访,随访时间18~24个月,平均21个月。X线片复查示,截骨端均达骨性愈合,愈合时间9~14周,平均11.5周。截骨端愈合后测量股胫角为165~170°,平均167.5°;下肢力线矫正满意。术后各时间点VAS评分均较术前显著降低,KSS评分较术前显著增加,比较差异有统计学意义(P0.05);术后各时间点间比较,差异均无统计学意义(P0.05)。与对照组比较,试验组术前血浆及关节滑液IL-1β、IL-6、IL-17含量均增高。差异均有统计学意义(P0.05);术后各时间点均较术前显著降低(P0.05),但均高于对照组(P0.05)。试验组术后各时间点血浆及关节滑液IL-1β、IL-6、IL-17含量均逐渐下降,但比较差异无统计学意义(P0.05)。结论 HTO可显著改善单纯内侧间室膝OA患者疼痛症状和关节功能,并在一定程度上降低患者体内IL-1β、IL-6、IL-17含量,但尚未恢复至正常水平。
[Abstract]:Objective to investigate the treatment of osteoarthritis of medial interventricular knee osteoarthritis by high tibial osteotomy. IL-1 尾 -IL-6 in plasma and synovial fluid after OAA. Methods from January 2011 to June 2014, 26 patients were treated with HTO because of simple medial compartment knee osteoarthritis (study group). Thirty volunteers with normal knee joints were used as normal control group (control group). The sex and age of the subjects in the two groups were studied. There was no significant difference in body mass index (BMI) between the two groups (P 0.05). In the experimental group, the time of osteotomy was recorded, the femoral tibial angle was measured, and the force line of lower extremity was evaluated. The knee joint function was evaluated by KSS, and the degree of knee pain was evaluated by visual analogue score (VASS) before and after operation. The venous blood of the elbow and the synovial fluid of the knee joint of the affected side were collected for 18 months. The levels of IL-6 / IL-17 in plasma and synovial fluid were measured by ELISA assay kit. Results all the patients in the experimental group were healed in the first stage after operation. All the patients were followed up for 18 ~ 24 months with an average of 21 months. The healing time was 9 ~ 14 weeks (mean 11.5 weeks). The femoral tibial angle was measured at the end of osteotomy with a mean of 167.5 掳. The VAS scores of all postoperative time points were significantly lower than those of preoperative ones, and the difference was statistically significant (P 0.05). There was no significant difference between each time point after operation (P 0.05). Compared with control group, IL-1 尾 -IL-6 in plasma and synovial fluid of the experimental group were compared with those in the control group before operation. The content of IL-17 was increased, and the difference was statistically significant (P 0.05). The levels of IL-1 尾 IL-6 in plasma and synovial fluid of the experimental group were significantly lower than those of the control group at each time point after operation, but were higher than that of the control group. The content of IL-17 decreased gradually, but the difference was not statistically significant (P 0.05). Conclusion HTO can significantly improve the pain symptoms and joint function in patients with simple medial compartment OA. To some extent, the level of IL-17 in IL-1 尾 was decreased, but the level of IL-17 was not recovered to normal level.
【作者单位】：沧州市中心医院骨二科;沧州市人民医院手术室;献县人民医院骨科;
【分类号】：R687.4
【正文快照】： 骨关节炎(osteoarthritis,O A是一■种复杂的关节滑膜及关节软骨炎性疾病m,由于炎性细胞因子破坏了软骨细胞的合成与分解代谢平衡,进而在O A发生与发展中起重要作用|2'31。膝关节O A发病过程中,IL-1(31451、IL-616—71具有重要作用,IL-1 7与O A之间亦存在密切联系|89]。膝关

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