骨关节炎患者血清和关节液一氧化氮及其合成酶变化的意义

Measurement of nitric oxide and its inducible synthase in sera and joint fluids of patients with osteoarthritis

目的 探讨骨关节炎 (OA)患者血清及关节液中一氧化氮 (NO)和诱生型一氧化氮合成酶 (iNOS)与病情程度及活动性的关系。方法 对 30例轻度 (n =7)、中度 (n =12 )、重度 (n =11)骨关节炎患者及 2 4例健康对照者血清及关节液中NO、iNOS、ESR、CRP的含量进行测定。结果 中、重度骨关节炎组血清中NO、iNOS水平比健康组升高 (P <0 0 1) ;三组骨关节炎关节液中NO、iNOS水平均比对照组明显升高 (P <0 0 0 1) ;重度骨关节炎组血清中NO、iNOS水平与关节液中NO、iNOS水平呈正相关 (r=0 5 89,P <0 0 1) ;重度骨关节炎组关节液中NO、iNOS水平与ESR、CRP呈正相关 (r =0 4 2 8,p <0 0 5 )。结论 iNOS及其产生的NO参与了OA的病变过程 ,是OA病程发展的重要机制。

Aim To investigate the relationship between the levels of nitric oxide(NO) and its inducible synthase(iNOS) in sera and joint fluids of patients with osteoarthritis (OA) and the activity of the disease.Methods The levels of NO, iNOS, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) in sera and joint fluids of 30 patients with mild, moderate or severe OA respectively and 24 healthy volunteers were measured.Results ① The levels of NO and iNOS in sera and joint fluids of patients with moderate and severe OA were higher than that of normal controls(P<0.01).② In comparison with that of normal controls,the levels of NO and iNOS in joint fluids of all patients with OA increased significantly (P<0.001).③ The levels of NO and iNOS in joint fluids of patients with severe OA correlated positively with that in sera(r=0.589, P<0.01).④ The levels of NO and iNOS in joint fluids of patients with moderate and severe OA correlated positively with the levels of serum ESR and CRP(r=0.428, P<0.05).Conclusion iNOS and iNOS-derived NO may mediate the pathogenesis and development of OA.