CAJ | 학술논문

目的：探讨髋关节液中Ⅱ型胶原羧基端端肽（ CTX-Ⅱ）含量与股骨头坏死软骨病变的关系。方法选择38例（43髋）股骨头坏死和6例（4髋、2膝）阴性对照患者，应用双抗体夹心酶标免疫法测定关节液中CTX-Ⅱ含量，比较各组间的差异及相关性。结果股骨头坏死各组关节液中CTX-Ⅱ的含量明显高于阴性组，ⅢA组与阴性组比较（ P＝0.109），ⅢB组、ⅢC组分别与阴性组比较（P＜0.01），三组间两两比较（P＜0.05）；＜6月组与阴性组比较（P＞0.05），6～11月组、≥12月组CTX-Ⅱ含量高于阴性组（P＜0.01），＜6月组CTX-Ⅱ含量低于6～11月组及≥12月组（P＜0.05），而6～11月组与≥12月组比较（ P＞0.05）；病因分组比较无差异（ P＞0.05）；股骨头坏死髋关节液中CTX-Ⅱ含量与塌陷程度、疼痛时间、病因等因素的Spearman秩相关系数分别为0.943、0.595（ P＜0.01），0.112（P＞0.05）。结论股骨头坏死关节液CTX-Ⅱ含量可作为生物标记物反映关节软骨病变程度，为临床制定合理治疗方案提供依据。
목적：탐토관관절액중Ⅱ형효원최기단단태（ CTX-Ⅱ）함량여고골두배사연골병변적관계。방법선택38례（43관）고골두배사화6례（4관、2슬）음성대조환자，응용쌍항체협심매표면역법측정관절액중CTX-Ⅱ함량，비교각조간적차이급상관성。결과고골두배사각조관절액중CTX-Ⅱ적함량명현고우음성조，ⅢA조여음성조비교（ P＝0.109），ⅢB조、ⅢC조분별여음성조비교（P＜0.01），삼조간량량비교（P＜0.05）；＜6월조여음성조비교（P＞0.05），6～11월조、≥12월조CTX-Ⅱ함량고우음성조（P＜0.01），＜6월조CTX-Ⅱ함량저우6～11월조급≥12월조（P＜0.05），이6～11월조여≥12월조비교（ P＞0.05）；병인분조비교무차이（ P＞0.05）；고골두배사관관절액중CTX-Ⅱ함량여탑함정도、동통시간、병인등인소적Spearman질상관계수분별위0.943、0.595（ P＜0.01），0.112（P＞0.05）。결론고골두배사관절액CTX-Ⅱ함량가작위생물표기물반영관절연골병변정도，위림상제정합리치료방안제공의거。
Objective To explore the relationship between the level of C-telopeptide of typeⅡcollagen ( CTX-Ⅱ) in the synovial fluid and the cartilage lesion of osteonecrosis of the femoral head (ONFH).Methods The synovial fluid liquid (2-5 ml) of 38 ONFH patients (43 hips) and six (four hips, two knees) negative patients were extracted in the operation.The CTX-Ⅱin the synovial fluid was measured by the double antibody sandwich enzyme-linked immunosorbent assay.The differences and correlation were compared between the groups.Results The CTX-Ⅱof the ONFH groups was significantly higher than that of the negative group.There was no significant difference (P>0.05) between the stageⅢA group and the negative group.The differences among the stageⅢB group, the stageⅢC group and the negative group were statistically significant by paired comparison ( P <0.01 ) .There was statistically significant difference ( P<0.05) between any two groups of stage Ⅲ.There was no significant difference ( P>0.05) between the less-than-six-month group and the negative group.The CTX-Ⅱresults in the 6-11 months group and the over-12-month group were higher than the negative group, and the difference was statistically significant (P<0.01).The patients in the less-than-six-month group had lower CTX-Ⅱlevel than the patients in the 6-11 months group and the over-12-month group;the differences were statistically significant (P<0.05).There was no significant difference (P>0.05) between the 6-11 months group and the over-12-month group.As for the etiology groups, there was no statistically significant difference (P>0.05).The spearman rank correlation coefficients of the CTX-Ⅱ level in the ONFH joint fluid with collapse extent, pain duration and etiology were 0.943, 0.595 (P <0.01), 0.112 (P >0.05), respectively.Conclusion CTX-Ⅱ in the ONFH joint fluid can be used as a biomarker reflected the degree of articular cartilage lesion, and the assessment can provide a guidance for the treatment of ONFH.