CAJ | 학술논문

目的：探讨膝骨性关节炎(knee osteoarthritis，KOA)患者关节液TNF-α和TGF-β1水平变化及其临床意义。方法选择我科住院90例KOA患者，依据X线影像分期分为早期患者30例(A组)，中期患者30例(B组)，晚期患者30例(C组)；健康志愿者30例为对照组。对四组患者关节液TNF-α和TGF-β1水平进行检测。结果KOA中、晚期关节液TGF-β1水平明显低于对照组(P<0.01)；KOA中、晚期关节液TNF-α水平明显高于对照组(P<0.01)；KOA早期关节液TNF-α和TGF-β1水平与对照组比较，无统计学意义(P>0.05)；而KOA早、中、晚期关节液TNF-α/TGF-β1水平明显高于对照组(P<0.01)；TNF-α与KOA分期呈正相关(r=0.930，P<0.01)；TGF-β1与KOA分期呈负相关(r=-0.849，P<0.01)；TNF-α/TGF-β1与KOA分期呈正相关(r=0.828，P<0.01)。结论 TNF-α和TGF-β1参与了KOA的形成和进展，关节液NF-α和TGF-β1水平能反映KOA的病变严重程度；关节液TNF-α/TGF-β1能早期发现KOA。
목적：탐토슬골성관절염(knee osteoarthritis，KOA)환자관절액TNF-α화TGF-β1수평변화급기림상의의。방법선택아과주원90례KOA환자，의거X선영상분기분위조기환자30례(A조)，중기환자30례(B조)，만기환자30례(C조)；건강지원자30례위대조조。대사조환자관절액TNF-α화TGF-β1수평진행검측。결과KOA중、만기관절액TGF-β1수평명현저우대조조(P<0.01)；KOA중、만기관절액TNF-α수평명현고우대조조(P<0.01)；KOA조기관절액TNF-α화TGF-β1수평여대조조비교，무통계학의의(P>0.05)；이KOA조、중、만기관절액TNF-α/TGF-β1수평명현고우대조조(P<0.01)；TNF-α여KOA분기정정상관(r=0.930，P<0.01)；TGF-β1여KOA분기정부상관(r=-0.849，P<0.01)；TNF-α/TGF-β1여KOA분기정정상관(r=0.828，P<0.01)。결론 TNF-α화TGF-β1삼여료KOA적형성화진전，관절액NF-α화TGF-β1수평능반영KOA적병변엄중정도；관절액TNF-α/TGF-β1능조기발현KOA。
Objective To explore the changes and clinical significance of joint fluid TNF-α and TNF-β1 levels in patients with knee osteoarthritis (KOA). Methods A total of 90 patients with KOA hospitalized in our hospital were selected. They were assigned to group A with 30 patients at early stage, group B with 30 patients at medium stage,and group C with 30 patients at advanced stage according to the stage of X ray; 30 healthy volunteers were in the con-trol group. Levels of joint fluid TNF-αand TNF-β1 were tested in four groups of patients. Results Levels of joint fluid TNF-β1 at medium and advanced stages of KOA were significantly lower than those in the control group, and the dif-ferences were significant (P<0.01); Levels of joint fluid TNF-α at medium and advanced stages of KOA were signifi-cantly higher than those in the control group, and the differences were significant(P<0.01); the difference of levels of joint fluid TNF-α and TNF-β1 at early stage of KOA was not significant compared with those in the control group(P>0.05);levels of TNF-α/TNF-β1 at early,medium and advanced stage of KOA were significantly higher than those in the control group(P<0.01);TNF-αwas positively correlated with KOA stage(r=0.930,P<0.01);TNF-β1 was nega-tively correlated with KOA stage(r=-0.849,P<0.01);TNF-α/TNF-β1 was positively correlated with KOA stage(r=0.828,P<0.01). Conclusion TNF-α and TNF-β1 are involved in the formation and progression of OA, and levels of joint fluid TNF-α and TNF-β1 are able to reflect the severity of KOA lesions; joint fluid TNF-α/TNF-β1 is able to detect KOA early.