老年女性膝骨关节炎患者骨代谢指标的表达及其对K-L分级的评估价值

Expression of Bone Metabolism Indexes in Elderly Female Patients with Knee Osteoarthritis and Their Assessment Value for K-L Classification

目的分析老年女性膝骨关节炎(KOA)患者骨代谢指标的表达情况及其对Kellgren-Lawrence(K-L)分级的评估价值。方法回顾性分析2019年1月至2021年12月南京中医药大学附属南京中医院骨伤科收治的120例老年女性KOA患者的临床资料,根据X线K-L分级将患者分为K-L1级组(24例)、K-L2级组(41例)、K-L3级组(37例)、K-L4级组(18例)。比较4组的一般资料、骨代谢指标[Ⅰ型胶原羧基端肽β降解产物(β-CTX)、Ⅰ型胶原氨基端肽(PⅠNP)],并分析老年女性KOA患者骨代谢指标对K-L分级的评估价值。结果各组血清β-CTX、PⅠNP水平比较差异有统计学意义(P<0.01),K-L2级组、K-L3级组、K-L4级组血清β-CTX、PⅠNP水平高于K-L1级组(P<0.05),K-L3级组和K-L4级组高于K-L2级组(P<0.05),且K-L4级组高于K-L3级组(P<0.05)。经Kendall′s tau-b相关性检验显示,血清β-CTX、PⅠNP与老年女性KOA患者K-L分级呈正相关(r=0.761,P<0.001;r=0.702,P<0.001);受试者工作特征曲线结果显示,血清β-CTX、PⅠNP评估老年女性KOA患者K-L分级的曲线下面积均>0.70,有一定评估价值且均以联合检测评估效能最佳。结论骨代谢指标与老年女性KOA患者K-L分级呈正相关,且骨代谢指标可有效评估老年女性KOA患者K-L分级。

Objective To analyze the expression of bone metabolism indexes in elderly female patients with knee osteoarthritis(KOA)and their assessment value for Kellgren-Lawrence classification(K-L).Methods The clinical data of 120 elderly female patients with KOA admitted to the Department of Orthopedics,Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from Jan.2019 to Dec.2021 were analyzed retrospectively.The patients were divided into a K-L1 group(24 cases),a K-L2 group(41 cases),a K-L3 group(37 cases)and a K-L4 group(18 cases)according to the X-ray K-L standard.The general data and bone metabolism indexes[typeⅠcollagen carboxy terminal peptideβdegradation products(β-CTX),typeⅠcollagen amino terminal peptide(PⅠNP)]of the four groups were compared,and the evaluation value of bone metabolic markers for K-L grading of KOA in elderly women was analyzed.Results There were statistically significant differences in serumβ-CTX and PⅠNP levels among all groups(P<0.01).The serumβ-CTX and PⅠNP levels in the K-L2,K-L3 and K-L4 groups were higher than those in the K-L1 group(P<0.05),and the serumβ-CTX and PⅠNP levels in the K-L3 and K-L4 groups were higher than those in the K-L2 group(P<0.05),the K-L4 group was higher than the K-L3 group(P<0.05).Kendall′s tau-b correlation test showed that serumβ-CTX and PⅠNP were positively correlated with K-L grade in elderly female patients with KOA(r=0.761,P<0.001;r=0.702,P<0.001).The receiver operating characteristic curve was drawn,and the results showed that,the area under the curve of serumβ-CTX and PⅠNP in the assessment of K-L grading in elderly female patients with KOA were>0.70,which had certain assessment value and the joint assessment efficiency was the best.Conclusion There is a positive correlation between bone metabolism indexes and K-L grade of elderly female patients with KOA,and bone metabolism indexes can effectively assess the K-L grade of elderly female patients with KOA.