膝骨性关节炎不同中医证型滑液中蛋白多糖和透明质酸含量的变化

Change of the proteoglycan and hyaluronic acid in different symptom type of knee OA in human synovial filud

目的:观察骨关节炎(OA)不同中医证型滑液中关节软骨基质蛋白多糖(PG)和透明质酸(HA)的变化为中医辨证分型提供参考依据。方法:60例膝骨性关节炎患者包括瘀血阻络(C组)、肾虚寒凝(D组)、肾虚髓亏(B组)3种证型各20例;10名正常人(A组)。收集以上患者和正常人的关节滑液,应用酶联免疫吸附测定(ELISA)法和放射免疫技术分别检测滑液样本中蛋白多糖和透明质酸的水平。结果:OA患者滑液中PG水平显著高于正常对照组,HA含量显著低于正常对照组(P<0·05)。C组滑液中PG水平最高,HA比另两组(B、D组)较高。D组PG水平次之,HA也降低。而在B组PG和HA均明显降低。结论:膝OA患者滑液中PG与HA含量在不同证型之间有差异,可将滑液中PG和HA含量作为中医分型的参考指标。

Objective ：To observe the changes of proteoglycan （PG） and hyaluronic acid （HA） in synovial fluid（SF） of osteoarthritis（OA） according to different symptom type of TCM ,from which may provide the biochemical index for diagnosis of OA. Methods：The SF of 60 patients with knee OA and 10 normal persons （control group, group A） were collected. Those patients were divided into three groups：blocrage of channel by blood stasis （group C ,20 cases） ;deficiency of kidney-Qi accumulation of cold （group D, 20 cases） ;deficiency of kidney-Qi and marrow（ group B,20 cases）, The PG and HA levels in SF were analyzed using an enzymelinked immunosorbent assay （ELISA） and radioimmunoassay, Results： The PG level in OA patients were significantly higher than those of the control group, on the contrary, the HA level were significantly lower than those of the control group. The PG level in group C were highest among 3 groups, then were those in group D. The PG and HA levels in SF in group B decreased sinificantly （P 〈 0. 05 ）. Conclusion：The PG and HA levels in SF of osteoarthritis patients were different from those of the control group, indicating that the content of PG and HA in SF of osteoarthritis can be used as biochemical index for diagnoses of OA.