摘要
目的研究血清中蛋白聚糖和Ⅱ型胶原水平与骨关节炎严重程度间的关系,及对手术后软骨代谢改变的反映。方法研究对象包括65例膝骨关节炎患者及22名正常人。45例患者分别行不同方式手术治疗,术后半年复查。正常人及患者术前和复查时抽取静脉血,摄下肢负重位X线片。应用酶联免疫吸附方法检测血清样本中蛋白聚糖及Ⅱ型胶原的水平。结果骨关节炎患者血清中蛋白聚糖及Ⅱ型胶原水平均显著高于正常对照组,差异有显著性意义(P<0.05)。血清中蛋白聚糖和Ⅱ型胶原水平在轻型骨关节炎组升高,在关节明显狭窄组水平最高,而在严重狭窄组明显降低。术后半年,全膝关节置换术组血清中蛋白聚糖水平较术前明显下降(P<0.05);截骨术组血清中Ⅱ型胶原水平较术前明显下降(P<0.05)。结论血清中蛋白聚糖和Ⅱ型胶原的水平与骨关节炎软骨的破坏程度、软骨细胞的合成反应及软骨的总量有关。蛋白聚糖和Ⅱ型胶原水平是反映软骨代谢改变的较敏感的指标。
Objective To investigate the relationship between the levels of proteoglycan and collagen type Ⅱ in serum and severity of knee osteoarthritis, and to determine whether the two markers could reflect the metabolic changes of cartilage after different knee operations. Methods Serum samples and roentgenographic data of 65 patients with knee osteoarthritis and 22 normal persons in controls were collected. Three different operations were performed for 45 patients respectively. These patients were followed up for half a year. The serum levels of proteoglycan and collagen type Ⅱ epitope were analysed using an enzyme-linked immunosorbent assay(ELISA). Results Epitope levels of proteoglycan and collagen type Ⅱ in serum of osteoarthritis patients were higher than those in control group. The serum levels of both markers in the group that the roentgenograph show minor narrowing of joint space were highest. Half a year after total knee replacement, the level of proteoglycan decreased significantly(P< 0.05). In high tibial osteotomy group, collagen type Ⅱ level in serum decreased significantly(P< 0.05). Conclusion The serum levels of proteoglycan and collagen type Ⅱ fragment are related with the grade of destruction of osteoarthritis cartilage, the synthetic response of chondrocytes and the total amount of cartilage. Proteoglycan and collagen type Ⅱ are sensitive markers reflecting the metabolic changes of articular cartilage.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2002年第12期705-708,共4页
Chinese Journal of Orthopaedics
基金
国家自然科学基金资助项目(39500167)
