骨性关节炎患者关节滑液中IL-17与疾病严重程度的相关性分析

发布时间：2018-10-21 19:44

【摘要】：第一部分IL-17在膝骨性关节炎关节液中的表达及意义目的：观察IL-17在膝骨性关节炎患者关节液中的表达。明确IL-17在膝骨性关节炎发病机制中的关联,探索IL-17在膝骨性关节炎致病过程中的作用,为揭示膝骨性关节炎发病机制提供理论和实验依据。方法：所有患者均来自2012年3月至2015年2月我院骨科。本研究标本来自两部分膝骨关节炎(Osteoarthritis,OA)组和正常对照组。膝OA组经影像学及临床标准明确诊断,且须行膝关节镜下关节清理术共40例。同时收集32例外伤致半月板或韧带损伤、断裂须行膝关节镜下修复或韧带重建的患者为正常对照组。二组之间在年龄,性别,体重指数方面无显著差异(P0.05)。手术过程中对关节液进行收集,采用注射器从关节腔中抽取约2-3 m1的关节液,并将其注入离心管当中,关节液收集后半小时内立即送实验室处理。检测方法采用酶联免疫吸附测定法(enzyme-linked immunosorbent assay, ELISA),对关节液中IL-17的含量进行测定。完成ELISA后,测出OD值,两组的IL-17浓度则通过绘制标准曲线求出。统计学分析应用SPSS 17.0统计分析软件。结果：正常对照组膝关节液中IL-17的含量为2.17±0.98 pg/ml,而在膝OA组中IL-17含量为6.37±2.53 pg/ml,统计分析正常对照组IL-17的含量与膝OA组关节滑液中的含量差异比较具有统计学意义(P0.05)。膝OA组关节液中IL-17的水平要显著高于正常对照组。结论：IL-17在膝骨关节炎的发病中起着重要的作用。膝OA关节液中IL-17的表达明显升高,这说明IL-17很可能共同参与了膝OA的病理过程,造成关节的破坏。第二部分膝骨性关节炎中IL-17与疾病严重程度的相关性分析目的：研究膝骨性关节炎患者关节液中IL-17的水平与膝关节炎严重程度的相关性。方法：纳入226名膝关节炎患者以及116名健康志愿者作为对照组。患者膝关节炎严重程度通过Western Ontario McMaster University Osteoarthritis Index (WOMAC)疼痛评分以及Kellgren-Lawrence(KL)分级系统进行评价,同时通过ELISA试验检测患者膝关节液IL-17的水平。结果：膝关节炎关节液中IL-17的水平明显高于对照组(P0.01),并且与膝关节炎的严重程度呈负相关性。IL-17的水平会随着疾病进程的推进逐渐减少,但无统计学差异。结论：IL-17可能在膝关节炎的发病过程中起了至关重要的作用,与膝关节炎引起的疼痛关系密切。阻断IL-17信号通路有望减轻由膝关节炎而带来的疼痛。
[Abstract]:The first part: the expression and significance of IL-17 in articular fluid of knee osteoarthritis objective: to observe the expression of IL-17 in articular fluid of patients with knee osteoarthritis. To clarify the association of IL-17 in the pathogenesis of knee osteoarthritis, to explore the role of IL-17 in the pathogenesis of knee osteoarthritis, and to provide theoretical and experimental basis for revealing the pathogenesis of knee osteoarthritis. Methods: all patients were from orthopedic department of our hospital from March 2012 to February 2015. The specimens were collected from two-part knee osteoarthritis (Osteoarthritis,OA) group and normal control group. In OA group, 40 cases were diagnosed by imaging and clinical criteria, and 40 cases were treated with arthroscopic debridement. 32 cases of meniscus or ligament injury caused by injury were collected as normal control group. There was no significant difference in age, sex and BMI between the two groups (P0.05). During the operation, the joint fluid was collected, about 2-3 M1 joint fluid was extracted from the joint cavity by syringe and injected into the centrifuge tube. The joint fluid was sent to the laboratory for treatment within half an hour after the joint fluid was collected. Methods Enzyme-linked immunosorbent assay (enzyme-linked immunosorbent assay, ELISA),) was used to determine the content of IL-17 in joint fluid. After completing ELISA, the OD value was measured, and the IL-17 concentration of the two groups was calculated by drawing the standard curve. SPSS 17.0 software was used for statistical analysis. Results: the content of IL-17 in the knee joint fluid was 2.17 卤0.98 pg/ml, in the normal control group and 6.37 卤2.53 pg/ml, in the OA group. The content of IL-17 in the normal control group was significantly different from that in the synovial fluid of the knee OA group (P0.05). The level of IL-17 in articular fluid of OA group was significantly higher than that of normal control group. Conclusion: IL-17 plays an important role in the pathogenesis of knee osteoarthritis. The expression of IL-17 in the joint fluid of knee OA was significantly increased, which suggested that IL-17 might be involved in the pathological process of OA in the knee joint, resulting in joint destruction. Part two the correlation between IL-17 and severity of knee osteoarthritis objective: to study the relationship between the level of IL-17 and the severity of knee osteoarthritis in patients with knee osteoarthritis. Methods: 226 knee arthritis patients and 116 healthy volunteers as control group. The severity of knee arthritis was evaluated by Western Ontario McMaster University Osteoarthritis Index (WOMAC) pain score and Kellgren-Lawrence (KL) grading system, and the IL-17 level of knee joint fluid was measured by ELISA test. Results: the level of IL-17 in the synovial fluid of knee arthritis was significantly higher than that in the control group (P0.01), and there was a negative correlation between the level of IL-17 and the severity of knee arthritis. The level of IL-17 decreased gradually with the progression of the disease, but there was no statistical difference. Conclusion: IL-17 may play an important role in the pathogenesis of knee arthritis and is closely related to the pain caused by knee arthritis. Blocking the IL-17 signaling pathway is expected to relieve pain caused by knee arthritis.
【学位授予单位】：武汉大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R684.3

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