CAJ | 학술논문

背景：白细胞介素1β和基质金属蛋白13能促进软骨细胞的分解代谢，抑制软骨细胞的合成修复能力，引起细胞外基质的降解，在骨关节炎的发生中有十分重要的作用。 　　目的：观察体外冲击波对兔膝骨关节炎软骨细胞中白细胞介素1β和基质金属蛋白酶13表达的影响。 　　方法：将30只新西兰兔随机分为治疗组、模型组、对照组，每组10只。治疗组和模型组均采用改良伸直位固定6周，制备兔膝骨关节炎模型。治疗组造模后给予体外冲击波治疗1次，能流密度0.1 mJ/mm2，冲击次数1000次。对照组不作任何处理。各组兔于治疗后4周处死，取膝关节液和关节软骨。苏木精-伊红染色和甲苯胺蓝染色法检测各组膝关节病理学形态改变，采用酶联免疫吸附法测定关节液白细胞介素1β水平，免疫组化法检测白细胞介素1β和基质金属蛋白酶13的表达。 　　结果与结论：治疗组和模型组关节液白细胞介素1β水平较对照组明显增高(P <0.01)，治疗结束后治疗组关节液白细胞介素1β水平较模型组下降(P <0.05)。治疗组和模型组软骨组织Mankin评分较对照组明显增高(P<0.01)，治疗结束后治疗组软骨组织Mankin评分较模型组下降(P<0.05)。治疗组和模型组软骨细胞白细胞介素1β和基质金属蛋白酶13阳性表达率较对照组明显增高(P<0.01)，治疗结束后治疗组软骨细胞白细胞介素1β和基质金属蛋白酶13阳性表达率较模型组下降(P<0.05)。结果可见体外冲击波能下调膝骨关节炎软骨细胞白细胞介素1β和基质金属蛋白酶13的表达，促进Ⅱ型胶原和蛋白聚糖的合成，从而对膝骨关节炎起防治作用。
배경：백세포개소1β화기질금속단백13능촉진연골세포적분해대사，억제연골세포적합성수복능력，인기세포외기질적강해，재골관절염적발생중유십분중요적작용。 　　목적：관찰체외충격파대토슬골관절염연골세포중백세포개소1β화기질금속단백매13표체적영향。 　　방법：장30지신서란토수궤분위치료조、모형조、대조조，매조10지。치료조화모형조균채용개량신직위고정6주，제비토슬골관절염모형。치료조조모후급여체외충격파치료1차，능류밀도0.1 mJ/mm2，충격차수1000차。대조조불작임하처리。각조토우치료후4주처사，취슬관절액화관절연골。소목정-이홍염색화갑분알람염색법검측각조슬관절병이학형태개변，채용매련면역흡부법측정관절액백세포개소1β수평，면역조화법검측백세포개소1β화기질금속단백매13적표체。 　　결과여결론：치료조화모형조관절액백세포개소1β수평교대조조명현증고(P <0.01)，치료결속후치료조관절액백세포개소1β수평교모형조하강(P <0.05)。치료조화모형조연골조직Mankin평분교대조조명현증고(P<0.01)，치료결속후치료조연골조직Mankin평분교모형조하강(P<0.05)。치료조화모형조연골세포백세포개소1β화기질금속단백매13양성표체솔교대조조명현증고(P<0.01)，치료결속후치료조연골세포백세포개소1β화기질금속단백매13양성표체솔교모형조하강(P<0.05)。결과가견체외충격파능하조슬골관절염연골세포백세포개소1β화기질금속단백매13적표체，촉진Ⅱ형효원화단백취당적합성，종이대슬골관절염기방치작용。
BACKGROUND:Interleukin-1βand matrix metal oproteinase-13 can promote the metabolism of chondrocytes, inhibit the capacity of synthesizing and repairing, induce the degradation of extracellular matrix, and play a crucial role in the occurrence of osteoarthritis. OBJECTIVE:To observe the effects of extracorporeal shock wave therapy on the interleukin-1βand matrix metal oproteinase-13 expression in rabbits with experimental knee osteoarthritis. METHODS:Thirty New Zealand rabbits were randomly and equal y divided into treatment group, model group and control group, with 10 rabbits in each group. Model of knee osteoarthritis was established in both the treatment group and model group, using modified plaster cast in extension position for 6 weeks. Then the rabbits of treatment group were treated with extracorporeal shock wave therapy, each 1 000 impulse, at the energy flux density of 0.1 mJ/mm2. There were no treatments in the control group. The rabbits in each group were sacrificed at 4 weeks after treatment, the knee synovial fluid and articular cartilage were col ected from the rabbits. The pathological changes of knee joint were detected using hematoxylin-eosin staining and toluidine blue staining. The interleukin-1βand matrix metal oproteinase-13 expression in the synovia was detected using ELISA and immunohistochemical staining respectively. RESULTS AND CONCLUSION:The interleukin-1βconcentration in the synovial fluid was significantly higher in the treatment group and model group than the control group (P<0.01), and the treatment group after treatment showed a lower concentration than the model group (P<0.05). Mankin scores in treatment group and model group were significantly increased compared with the control group (P<0.01), and the treatment group after treatment showed a lower score than the model group (P<0.05). The interleukin-1βand matrix metal oproteinase-13 positive expression rates in the treatment group and model group were significantly increased compared with the control group (P<0.01), and the treatment group after treatment showed a lower rate than the model group (P<0.05). The extracorporeal shock wave therapy can downregulate the expression of interleukin-1βand matrix metal oproteinase-13, promote the synthesis of new col agen.