CAJ | 학술논문

目的探讨血清及关节液白细胞介素(IL)-1β,IL-6,肿瘤坏死因子(TNF)-α与伴有骨髓水肿的膝骨关节炎(KOA)的相关性.方法收集我院KOA患者331例,根据膝关节磁共振成像(MRI)分为骨髓水肿组(172例)和非骨髓水肿组(159例),分别收集其临床症状、骨关节指数( WOMAC)评分,并同期检测其血清和关节液中IL-1β,IL-6,TNF-α水平,采用单因素方差分析比较2组之间的差异,Spearman相关分析探讨其炎症指标水平与骨髓水肿发生程度及其临床指标的相关性.结果 ①KOA患者血清及关节液IL-1β、IL-6,TNF-α表达水平均呈正相关(血清r=0.24,0.38；关节液r=0.20,0.29；P均＜0.05)；IL-6与TNF-α水平呈正相关(血清r=0.31,P＜0.05；关节液r=0.33,P＜0.05).②KOA伴骨髓水肿组内,血清及关节液IL-6和TNF-α水平较KOA不伴骨髓水肿组高(血清F=8.139,7.172；关节液F=9.201,7.001,P均＜0.05)；③血清及关节液IL-6,TNF-α水平与KOA伴发骨髓水肿容积积分(血清rs=0.27,0.26；关节液rs=0.29,0.32；P均＜0.05)和程度积分(血清r,=0.29,0.27；关节液r,=0.29,0.31；P均＜0.05)呈正相关；④血清及关节液IL-1β,IL-6,TNF-α在伴有滑膜炎组的KOA中明显升高(骨髓水肿组血清F=3.931,5.866,5.514；关节液F=4.211,5.202,5.972;P均＜0.05.非骨髓水肿组血清F=3.513,3.114,7.112;关节液F=3.722,3.965,8.891；P均＜0.05).结论 IL-1β,IL-α,TNF-α在KOA伴有滑膜炎时明显升高,在KOA伴骨髓水肿时尤以IL-6,TNF-α升高明显.
목적 탐토혈청급관절액백세포개소(IL)-1β,IL-6,종류배사인자(TNF)-α여반유골수수종적슬골관절염(KOA)적상관성.방법 수집아원KOA환자331례,근거슬관절자공진성상(MRI)분위골수수종조(172례)화비골수수종조(159례),분별수집기림상증상、골관절지수( WOMAC)평분,병동기검측기혈청화관절액중IL-1β,IL-6,TNF-α수평,채용단인소방차분석비교2조지간적차이,Spearman상관분석탐토기염증지표수평여골수수종발생정도급기림상지표적상관성.결과 ①KOA환자혈청급관절액IL-1β、IL-6,TNF-α표체수평균정정상관(혈청r=0.24,0.38；관절액r=0.20,0.29；P균＜0.05)；IL-6여TNF-α수평정정상관(혈청r=0.31,P＜0.05；관절액r=0.33,P＜0.05).②KOA반골수수종조내,혈청급관절액IL-6화TNF-α수평교KOA불반골수수종조고(혈청F=8.139,7.172；관절액F=9.201,7.001,P균＜0.05)；③혈청급관절액IL-6,TNF-α수평여KOA반발골수수종용적적분(혈청rs=0.27,0.26；관절액rs=0.29,0.32；P균＜0.05)화정도적분(혈청r,=0.29,0.27；관절액r,=0.29,0.31；P균＜0.05)정정상관；④혈청급관절액IL-1β,IL-6,TNF-α재반유활막염조적KOA중명현승고(골수수종조혈청F=3.931,5.866,5.514；관절액F=4.211,5.202,5.972;P균＜0.05.비골수수종조혈청F=3.513,3.114,7.112;관절액F=3.722,3.965,8.891；P균＜0.05).결론 IL-1β,IL-α,TNF-α재KOA반유활막염시명현승고,재KOA반골수수종시우이IL-6,TNF-α승고명현.
Objective To investigate the correlation of the serum and synovial fluid interleukin (IL)-1β,IL-6,tumor necrosis factor (TNF)-α and bone marrow edema with osteoarthritis of the knee (KOA).Methods The clinical data of 331 KOA patients were included and all patients had knee MRI.Bone marrow edema were detected in 172 cases and 159 cases had non-bone marrow edema.The clinical symptoms,WOMAC score,and the serum and synovial fluid IL-1β,IL-6,TNF-α levels were compared using One-way ANOVA analysis and Spearman's correlation analysis.Results ① The serum and synovial fluid IL-1β,IL-6,TNF-α in osteoarthritis was positively correlated (serum r=0.24,0.38,0.31; synovial fluid r=0.20,0.29,0.33 ; all P＜0.05) ; ② The serum and synovial fluid IL-6 and TNF-α levels of osteoarthritis with bone marrow edema were significantly higher than those of the osteoarthritis without bone marrow edema (serum F=8.139,7.172; synovial fluid F=9.201,7.001; all P＜0.05); ③ The serum and synovial fluid TNF-α,IL-6 levels was associated with osteoarthritis with bone marrow edema in volume (serum r,=0.27,0.26; synovial fluid rs=0.29,0.32; all P＜0.05) and severity (serum rs=0.29,0.27; synovial fluid rs=0.29,0.31; all P＜0.05); ④ The serum and synovial fluid IL-1β,IL-6,TNF-α of osteoarthritis with synovitis was significantly higher than that of osteoarthritis without synovitis group (group of bone edema:serum F=3.931,5.866,5.514; synovial fluid F=4.211,5.202,5.972; all P＜0.05.non-bone edema patients:serum F=3.513,3.114,7.112; synovial fluid F=3.722,3.965,8.891; all P＜0.05).Conclusion IL-1β,IL-6,TNF-α are elevated in osteoarthritis with synov-itis.IL-6 and TNF-α are elevated significantly in knee osteoarthritis with bone marrow edema in particular.