摘要
目的探讨不同关节软骨损伤情况下关节滑膜的表现。方法收集2001—2008年关节镜手术337例339膝,其中男性161例,女性176例;年龄11~82岁,平均43岁。采用Outerbridge评分标准分别对髌骨面、股骨髌面、股骨内侧髁、股骨外侧髁、胫骨内侧髁和胫骨外侧髁共6个区域的关节软骨损伤病理变化情况进行评分,并将评分累加。对滑膜采用Ayral评分法,对膝关节滑膜9个区域进行评分,按公式计算出滑膜炎评分。结果软骨损伤评分和滑膜炎评分做Spearman相关分析结果表明软骨损伤评分与滑膜炎评分呈正相关（r=0.690,P〈0.01）。当软骨损伤评分为零分时,将年龄和滑膜评分作Spearman相关分析,结果表明年龄与滑膜炎评分呈正相关（r=0.353,P〈0.01）;性别与滑膜炎两者之间无相关性（r=0.020,P=0.827）。结论随着软骨损伤程度逐步加重,滑膜炎程度亦同时加重;然而,随着滑膜炎程度逐步加重,软骨损伤程度并不一定加重（出现最严重滑膜炎时,软骨也不一定有损伤）;并且,年龄因素对滑膜炎程度起重要作用。由此可以得出,软骨损伤对滑膜炎起决定作用,但同时,滑膜炎受多种因素影响,滑膜炎并不具备提示软骨损伤,并且加重骨关节炎的作用。
Objective To determine the manifestations of synovial membrane under different conditions of ar- ticular cartilage injury, thus offering the basis for scientific researches and treatments. Methods We recruited 337 patients （161 males, 176 females, age： 11-82 years, mean： 43 years） who underwent arthroscopic operations between 2001 and 2008, giving rise to a total of 339 knees. Using the Outerbridge＇s score system, we evaluated the degree of articular cartilage injury on the patellar and femoral patellar surface, medial femoral condyle, lateral condyle of femur, medial condyle and lateral condyle of tibia, which entailed scoring of their pathological changes and summation of re- spective score. Using the Ayral＇s score, we also evaluated the degree of synovial membrane hyperplasia in 9 regions of the knee joint synovial, resulting in the synovitis scores. Results Spearman correlation analysis suggested that carti- lage injury score and synovitis score were positively correlated （r=0.690, P〈0.01）. For those with nil cartilage injury score, the correlation analysis between age and synovial score showed a positive correlation （r=0.353, P〈0.01）. There was no marked correlation between gender and synovitis score （r=0.020, P=0.827）. Conclusion As with an ad- vanced injury of the cartilages, there was a trend towards an increased severity of synovitis, which in turn did not con- tribute to more severe cartilage injury, as evidenced by the fact that cartilage might not have been injured in the most severe synovitis. The age also contributes to an increased severity of synovitis. Therefore, cartilage injury plays a deci- sive role in the pathogenesis of synovitis, which however, is affected by multiple factors. Synovitis alone is not an indi- cator of cartilage injury but may contribute to osteoarthritis.
出处
《中国药物与临床》
CAS
2013年第12期1555-1557,共3页
Chinese Remedies & Clinics
关键词
骨关节炎
软骨疾病
滑膜炎
Osteoarthritis
Cartilage disease
Synovitis
