膝关节液中生物学标记物Ⅱ型胶原羧基端端肽的检测及临床意义

Measurement and clinical significance of CTX-Ⅱ level in synovial fluid of the knees

目的探讨膝关节液中Ⅱ型胶原羧基端端肽(CTX-Ⅱ)含量与关节软骨损伤和滑膜炎两种病变程度的关系。方法采用ELISA法对膝关节骨性关节炎37例患者(骨性关节炎组,即OA组)、膝关节其他疾病34例患者(非OA组)关节液中CTX-Ⅱ含量进行检测,并在关节镜下利用Outerbridge软骨损伤评分法和Ayral滑膜炎评分法对软骨损伤程度和滑膜炎程度进行评价。结果OA组关节液中CTX-Ⅱ含量高于非OA组(t=-7.558,P<0.05);Outerbridge软骨损伤累计评分≥10分组关节液CTX-Ⅱ的含量高于Outerbridge软骨损伤累计评分<10分组(t=-7.235,P<0.05);Ayral滑膜炎评分≥60分组关节液CTX-Ⅱ的含量高于Ayral滑膜炎评分<60分组(t=-5.113,P<0.05);71例膝关节疾病患者CTX-Ⅱ含量除主要与Outerbridge软骨损伤累计评分呈正相关外(r=0.743,P<0.05),还与Ayral滑膜炎评分呈正相关(r=0.706,P<0.05);OA组中Out-erbridge软骨损伤累计评分与Ayral滑膜炎评分呈正相关(r=0.418,P<0.05);OA组中CTX-Ⅱ含量与Outerbridge软骨损伤累计评分(r=0.533,P<0.05)和Ayral滑膜炎评分均呈正相关(r=0.522,P<0.05)。结论膝关节液中CTX-Ⅱ的含量除主要反映关节软骨损伤累计程度外,在一定程度上还反映关节滑膜炎程度;膝关节液CTX-Ⅱ含量升高提示软骨损伤程度较重。

Objective To explore the relationship of the CTX-Ⅱ （ C-telopeptide of type Ⅱ colla- gen , CTX -Ⅱ ） level in the synovial fluid of the knee with the degree of cartilage injury and synovitis. Methods 37 patients with knee osteoarthritis （OA group ）, 34 patients with other knee diseases （non-OA group） were studied. The CTX-Ⅱ level in the synovial fluid was measured by enzyme linked immunoassay. The degree of cartilage injury was assessed with Outerbridge＇ s score system and the degree of synovitis with Ayral＇ s score system under arthroscopy. Results The results showed that the CTX-Ⅱ level in the synovial fluid of OA group was higher（t = -7. 558, P 〈0. 05） than that of non - OA group. The CTX-Ⅱ level in the synovial fluid of the knees was higher in those with accumulative Outerbridge＇ s score≥ 10 than in those with the score 〈 10 （t = - 7. 235, P 〈 0. 05 ）. The CTX-Ⅱ level in the synovial fluid of the knees was higher in those with Ayral＇ s score ≥ 60 than in those with the score 〈 60 （ t = - 5. 113, P 〈 0. 05 ）. The CTX-Ⅱ level in the synovial fluid of the knees was correlated positively with accumulative Outerbridge＇ s score （ r = 0. 743, P 〈 0. 05 ） , and also positively related with Ayral＇ s score （ r = 0. 706,P 〈0. 05） ,especially with Outerbridge＇ s score in 71 knees. The Outerbridge＇ s score was correlated positively with Ayral ＇ s score in OA （ 1 = 0. 418,P 〈 0. 05 ） , and the CTX-Ⅱ level in the synovial fluid level in OA correlated positively with cartilage injury scores （ r = 0. 533, P 〈 0. 05 ） and synovitis scores （ r = 0. 522,P 〈 0. 05）. Conclusion The CTX-Ⅱ level in the synovial fluid of the knee can be regarded as a biomarker to reflect the degree of accumulative cartilage injury and synovitis. The accumulative cartilage injury will be more severe when the CTX-Ⅱ level in the synovial fluid of the knee is increasing.