CAJ | 학술논문

目的 MRI测定膝OA髌上囊渗液量,探讨其与疼痛及炎症因子(IL-6、IL-17、IL-23)的关系.方法选取膝OA患者204例.拍摄膝关节MRI片,用OSIRIS软件测定膝关节髌上囊渗液,包括渗液量的等级(0～3级)和渗液最大面积(cm2).测定血清IL-6、IL-17及IL-23水平.问卷评定患者关节疼痛症状,包括WOMAC评分及Lequesne指数,详细记录患者的一般情况,计算BMI等.应用t检验,x2检验,多元线性回归分析或Logistic回归进行分析.结果 ①204例患者,年龄(55±8)岁,其中女性176例(86.3％).生理性渗液(0～1级)83例(47.9％),病理性渗液(2～3级)90例(52.1％).②与低等级渗液量组相比,高等级渗液量组患者的年龄、体力劳动强度、血尿酸及Lequesne指数均升高(P均＜0.05).③髌上囊渗液最大面积与患者年龄呈正相关(r=0.208,P=0.006),与BMI呈正相关(r=0.171,P=0.027),与体力劳动强度呈正相关(r=0.189,P=0.013).④Logistic回归分析示排除性别、年龄、BMI的影响后发现,髌上囊渗液等级与Lequesne指数呈正相关[OR=1.120,95％ CI(1.011,1.241),P=0.029],与IL-23呈负相关[OR=0.768,95％CI(0.598,0.986),P=0.038],与WOMAC评分、IL-6、IL-17无显著相关性.结论膝OA患者中病理性渗液发生率高达52.1％.髌上囊渗液量与疼痛呈正相关,与IL-23呈负相关.
목적 MRI측정슬OA빈상낭삼액량,탐토기여동통급염증인자(IL-6、IL-17、IL-23)적관계.방법 선취슬OA환자204례.박섭슬관절MRI편,용OSIRIS연건측정슬관절빈상낭삼액,포괄삼액량적등급(0～3급)화삼액최대면적(cm2).측정혈청IL-6、IL-17급IL-23수평.문권평정환자관절동통증상,포괄WOMAC평분급Lequesne지수,상세기록환자적일반정황,계산BMI등.응용t검험,x2검험,다원선성회귀분석혹Logistic회귀진행분석.결과 ①204례환자,년령(55±8)세,기중녀성176례(86.3％).생이성삼액(0～1급)83례(47.9％),병이성삼액(2～3급)90례(52.1％).②여저등급삼액량조상비,고등급삼액량조환자적년령、체력노동강도、혈뇨산급Lequesne지수균승고(P균＜0.05).③빈상낭삼액최대면적여환자년령정정상관(r=0.208,P=0.006),여BMI정정상관(r=0.171,P=0.027),여체력노동강도정정상관(r=0.189,P=0.013).④Logistic회귀분석시배제성별、년령、BMI적영향후발현,빈상낭삼액등급여Lequesne지수정정상관[OR=1.120,95％ CI(1.011,1.241),P=0.029],여IL-23정부상관[OR=0.768,95％CI(0.598,0.986),P=0.038],여WOMAC평분、IL-6、IL-17무현저상관성.결론 슬OA환자중병이성삼액발생솔고체52.1％.빈상낭삼액량여동통정정상관,여IL-23정부상관.
Objective To explore the association of suprapatellar pouch effusion with knee pain and serum levels of interleukin (IL)-6,IL-17,IL-23 in patients with knee osteoarthritis measured by magnetic resonance imaging (MRI).Methods 204 patients with knee osteoarthritis were enrolled into the study.Suprapatellar pouch effusion was measured by OSIRIS in both grade (0-3) and maximum area (cm2).Serum IL-6,IL-17,IL-23 were measured.Knee pain was assessed by Western Ontario and McMasters osteoarthritis index (WOMAC) questionnaire and Lequesne index.Characteristics of patients were recorded and body mass index (BMI) was calculated.Student t test or Chi-square test was used to compare means or proportions.Multivariable linear regression or logistic regression was used to determine risk factors (α=0.05).Results ① In the 204 patients [mean age (55±8) years,86.3％ were females],the prevalence of physiologic effusion (≤ 1) was 47.9％ while moderate or larger (≥2) effusion was 52.1％.② The age,labour intensity,serum levels of uric acid (sUA) and Lequesne index of higher grade effusion group were higher (P＜0.05) compared with lower grade effusion group.③ Suprapatellar pouch effusion maximum area was positively correlated with age (r=0.208,P=0.006),BMI (r=0.171,P=0.027) and labour intensity (r=0.189,P=0.013).④ Adjusted for age,gender and BMI,the results of Logistic regression analysis showed that:suprapatellar pouch effusion grades were positively correlated with Lequesne index [OR=1.120,95％CI(1.011,1.241),P=0.029] and negatively correlated with IL-23 [OR=0.768,95％CI (0.598,0.986),P=0.038].Suprapatellar pouch effusion was not independently associated with WOMAC index,IL-6 and IL-17.Conclusion The prevalence of suprapatellar pouch pathological effusion is 52.1％ in knee osteoarthritis.Suprapatellar pouch effusions is positively correlated with knee pain (Lequesne index) and negatively conrelated with IL-23.