不同年龄段骨关节炎患者关节滑液中基质蛋白多糖的变化

Alteration of proteoglycan in synovial fluid of joint in osteoarthritis patients of different ages

目的:通过观察不同年龄段骨关节炎患者滑液中关节软骨基质蛋白多糖的变化与正常人比较,探索建立早期骨关节炎滑液中生化指标判断标准。方法:选择2002-01/2003-04上海中医药大学附属曙光医院骨科门诊治疗的膝关节骨关节炎患者60例,平均年龄47岁。无明显骨赘形成和关节间隙狭窄影像学表现,患者知情并同意。按年龄分为30～39岁组,平均年龄35.1岁;40～49岁组,平均年龄44.9岁;≥50岁组,平均年龄65.4岁。选择同期无关节疾患的正常者10例为正常对照组,参与者均知情同意,平均年龄38.7岁。收集患者和正常人的关节滑液2～5mL,应用酶联免疫吸附测定法检测滑液样本中蛋白多糖的水平。结果:纳入患者60例,正常者10人,均进入结果分析。应用酶联免疫吸附测定法检测不同年龄段骨关节炎组与正常组关节滑液中蛋白多糖含量:正常对照组滑液中蛋白多糖水平为(29.8±8.4)μg/L,30～39岁组升高[(94.9±74.2)μg/L,40～49岁达到最高[(288.7±118.6)μg/L,P<0.01],≥50岁组明显降低[(178.6±126.1)μg/L],但仍高于正常对照组和30～39岁组(P<0.01)。结论:骨关节炎患者滑液中蛋白多糖含量明显高于正常对照组,提示骨关节炎患者关节滑液中蛋白多糖含量可以作为判断早期骨关节炎的生化指标。

AIM： By observing the changes of proteoglycan of articular cartilage matrix from synovial fluid in patients with osteoarthritis at different ages and compare with the common people, to explore the biochemical index standard in the synovial fluid in the establishment of earlier period osteoarthritis. METHODS： Sixty patients with knee osteoarthritis, who were treated in the out-patient clinic of Department of Orthopaedics, Shuguang Affiliated Hospital, Shanghai University of Traditional Chinese Medicine, were selected from January 2002 to April 2003, 47 years old on average. There were insignificant osteophyma formation and screenage expression of joint space constriction with the knowledge and agreement of the patients. According to the ages, they were divided into 30-39 years group with 35.1 years old on average; 40-49 years group with 44.9 years old on average; ≥ 50 years group with 65.4 years old on average. Ten common people without joint disease at synchronization were selected as normal control group with the knowledge and agreement of the participators and 38.7 years old on average. The joint synovial fluid of 2-5 mL of the patients and the common people were collected respectively. The level of proteoglycan in the synovial fluid sample was detected by the enzyme-linked immunosorbent assay （ELISA）. RESULTS： Sixty patients and 10 common people were involved in the result analysis. The content of proteoglycan in the joint synovial fluid in the osteoarthritis group and normal group at different ages was detected by the ELISA method： The level of the proteoglycan in the synovial fluid in the normal control group was （29.8±8.4）μ/L. It decreased in the 30-39 years group [（94.9±74.2）μg/L]; It reached the peak at 40-49 yeas old [（288.7±118.6 ）μg/L, P 〈 0.01]; It decreased significantly in the ≥50 years group [（178.6±126,1）μg/L]; But it was still higher than that in the normal control group and 30-39 years group （P 〈 0.01）. CONCLUSION： The level of the proteoglyean in the synovial fluid in the patients with osteoarthritis is significantly higher than that in the normal control group, which indicates that the content of proteoglycan in joint synovial fluid in the patients with osteoarthritis can be used as biochemical index to judge the osteoarthritis in the earlier period.