CAJ | 학술논문

目的：玻璃酸钠治疗不同 Kellgren_Lawrence 分级骨关节炎患者，了解治疗前后膝关节液中微小 RNA_140（microRNA_140，miR_140）的表达变化，为更好的论证 miR_140与骨关节炎之间的因果关系打下基础。方法分别收集玻璃酸钠治疗不同 Kellgren_Lawrence 分级膝关节骨关节炎患者前、后关节液各40例，共80例（Ⅰ级组治疗前后各10例、Ⅱ级组治疗前后各10例、Ⅲ级组治疗前后各10例、Ⅳ级组治疗前后各10例），所有患者治疗前后均进行 HSS评分。应用实时荧光定量聚合酶链反应，检测玻璃酸钠治疗前、后关节液中 miR_140的表达。以 U6snRNA 为内参，求出每个样本的 Ct 值。结果与治疗前相比，HSS 评分、miR_140表达量均升高，Ⅰ级组、Ⅱ级组、Ⅲ级组治疗前后 HSS评分、miR_140表达量差异有统计学意义（P ＜0.05），Ⅳ级组治疗前后 HSS 评分、miR_140表达量差异无统计学意义（P＞0.05），Ⅳ级组 HSS 评分、miR_140的表达量与前三组比较，差异有统计学意义（P ＜0.05）；骨关节炎的不同分级与miR_140的表达量增加水平呈负相关（r ＝_0.825，P ＜0.05）。结论轻中度骨关节炎通过关节腔注射玻璃酸钠治疗，疗效肯定；玻璃酸钠对不同分级骨关节炎患者治疗前后膝关节液中的 miR_140表达水平上调，并且和骨关节炎不同分级呈负相关，miR_140可能作为新的治疗手段以及判断预后，可能参与骨关节炎的发病机制中起着重要作用。
목적：파리산납치료불동 Kellgren_Lawrence 분급골관절염환자，료해치료전후슬관절액중미소 RNA_140（microRNA_140，miR_140）적표체변화，위경호적론증 miR_140여골관절염지간적인과관계타하기출。방법분별수집파리산납치료불동 Kellgren_Lawrence 분급슬관절골관절염환자전、후관절액각40례，공80례（Ⅰ급조치료전후각10례、Ⅱ급조치료전후각10례、Ⅲ급조치료전후각10례、Ⅳ급조치료전후각10례），소유환자치료전후균진행 HSS평분。응용실시형광정량취합매련반응，검측파리산납치료전、후관절액중 miR_140적표체。이 U6snRNA 위내삼，구출매개양본적 Ct 치。결과여치료전상비，HSS 평분、miR_140표체량균승고，Ⅰ급조、Ⅱ급조、Ⅲ급조치료전후 HSS평분、miR_140표체량차이유통계학의의（P ＜0.05），Ⅳ급조치료전후 HSS 평분、miR_140표체량차이무통계학의의（P＞0.05），Ⅳ급조 HSS 평분、miR_140적표체량여전삼조비교，차이유통계학의의（P ＜0.05）；골관절염적불동분급여miR_140적표체량증가수평정부상관（r ＝_0.825，P ＜0.05）。결론경중도골관절염통과관절강주사파리산납치료，료효긍정；파리산납대불동분급골관절염환자치료전후슬관절액중적 miR_140표체수평상조，병차화골관절염불동분급정부상관，miR_140가능작위신적치료수단이급판단예후，가능삼여골관절염적발병궤제중기착중요작용。
Objective To examine the expression of microRNA_140(miR_140)after treatment of Sodium Hyaluronate in osteoarthritis(OA)graded by diagnosis criteria of Kellgren and Lawrence and to provide a basis of relation between miR_140 and OA development. Methods Knee synovial fluid specimens were collected in 40 OA patients by treatment of Sodium Hya_luronate. 80 cases were included. The OA patients was divided into 4 groups according to diagnosis criteria of Kellgren and Lawrence:gradeⅠgroup before and after treatment(n = 10、nˊ = 10),gradeⅡgroup before and after treatment(n = 10、nˊ =10),gradeⅢgroup before and after treatment(n = 10、nˊ = 10),and gradeⅣgroup before and after treatment(n = 10、nˊ = 10). All patients were respectively scored with HSS before and after treatment of Sodium Hyaluronate. The expression of miR_140 were detected by qPCR,U6 snRNA was the reference control,and calculated Ct value. Results The HSS score and expression level of miR_140 after treatment was much higher than that before treatment. There was significant difference in the grade Ⅰgroup,grade Ⅱ group,grade Ⅲ group(P < 0. 05),while the grade Ⅳ group was not(P > 0. 05). HSS score and expression level of miR_140 was significant difference between the grade Ⅳ group and grade Ⅰ group,grade Ⅱ group and grade Ⅲ group (all P < 0. 05). The expression change of miR_140 was negatively related to the grade of OA(r = _ 0. 825,P < 0. 05). Con_clusion Efficacy was sure to the mild or moderate OA by treatment of Sodium Hyaluronate. The expression of miR_140 increases in the knee synovial fluid after treatment by Sodium Hyaluronate,and is negatively related to the severity of OA. MiR_140 may be used as indicator of efficacy and judgment prognosis and this may be key role in the occurrence and development of OA.