CAJ | 학술논문

目的：探讨膝骨关节炎（OA）患者关节结构改变与关节疼痛等症状之间的关系。方法收集102例膝OA患者（91例女性），平均年龄55岁，应用WOMAC评分量表对患者临床症状，即关节疼痛感、僵硬感、关节功能进行评分。关节结构改变应用X线和MRI技术测定，对患者膝关节X线片进行骨赘（OP）（0～3分）及关节间隙狭窄（JSN）评分（0～3分），对MRI进行软骨缺损（CD）（0～4分）及骨髓病变（BML）评分（0～3分），分析其与关节疼痛等症状的关系。结果膝OA不同疼痛程度间，JSN和CD的严重程度差异无统计学意义（χ2值为0.936和2.168，P均＞0.05），而OP和BML的严重程度比较差异有统计学意义（χ2值为7.664和10.737， P均＜0.05）。Spearman相关分析发现：JSN及CD与关节疼痛感、僵硬感及关节功能均无明显相关，OP与膝关节疼痛感及关节功能相关（rS为0.380及0.235，P均＜0.05），BML与关节疼痛相关（rS＝0.342，P＜0.05）。结论 OA患者关节疼痛程度与关节结构的改变有关，OP和BML是影响关节疼痛及关节功能的主要原因，而JSN和CD与关节疼痛等无明显相关。
목적：탐토슬골관절염（OA）환자관절결구개변여관절동통등증상지간적관계。방법수집102례슬OA환자（91례녀성），평균년령55세，응용WOMAC평분량표대환자림상증상，즉관절동통감、강경감、관절공능진행평분。관절결구개변응용X선화MRI기술측정，대환자슬관절X선편진행골췌（OP）（0～3분）급관절간극협착（JSN）평분（0～3분），대MRI진행연골결손（CD）（0～4분）급골수병변（BML）평분（0～3분），분석기여관절동통등증상적관계。결과슬OA불동동통정도간，JSN화CD적엄중정도차이무통계학의의（χ2치위0.936화2.168，P균＞0.05），이OP화BML적엄중정도비교차이유통계학의의（χ2치위7.664화10.737， P균＜0.05）。Spearman상관분석발현：JSN급CD여관절동통감、강경감급관절공능균무명현상관，OP여슬관절동통감급관절공능상관（rS위0.380급0.235，P균＜0.05），BML여관절동통상관（rS＝0.342，P＜0.05）。결론 OA환자관절동통정도여관절결구적개변유관，OP화BML시영향관절동통급관절공능적주요원인，이JSN화CD여관절동통등무명현상관。
Objective To explore the associations between joint structure changes and the symptoms in knee osteoarthritis (OA). Methods 102 knee OA patients (91 women, 11 men ) with mean age of 55 years were recruited. The symptoms was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC), which consists of pain, joint stiffness and physical function. Joint structure changes were evaluated by X-ray and MRI. Radiographs of both knees were read for joint space narrowing and osteophytes (0-3), and 1.5T MRI were assessed for the bone marrow lesions and cartilage defects(0-3). Results The severity of JSN and CD showed no significant difference with different degrees of pain (χ2=0.936 and 2.168, both P>0.05), while the severity of OP and BML was statistically significant different(χ2=7.664 and 10.737, both P<0.05). Spearman analysis revealed that there was not significant correlation between joint space narrowing or cartilage defects with pain, stiffness and joint function, but the significant positive correlation were observed between the osteophytes with pain and joint function ( rs=0.380 and 0.235 , both P<0.05), and the MRI bone marrow lesions and pains was positively correlated too(rs=0.342, P<0.05). Conclusions There is correlation between joint structure changes and clinical symptoms such as pain, stiffness and joint function. MRI-defined BML and radiographic defined osteophytes may be the main reasons of pain and joint function, while the joint space narrowing and cartilage defects are not correlated with pain.