血清和关节液透明质酸含量的测定及其意义

Determination and Significance on the Contents of Hyaluronic Acid in Serum and Synovial Fluid

目的:探讨骨性关节炎(OA)患者血清和关节液透明质酸(HA)含量与OA病变程度的关系。方法:采用酶联免疫吸附试验(ELISA)检测膝关节疾病122例(128膝)患者的血清和关节液HA含量,并对软骨损伤及滑膜炎症程度进行评价。结果:OA组血清HA含量、软骨损伤评分及滑膜炎评分均高于非OA组(P<0.01),但关节液HA含量低于非OA组(P<0.01)。OA组血清HA含量与年龄、软骨损伤评分及滑膜炎症程度评分均呈正相关(P<0.05),无性别差异(P>0.05);关节液HA含量与软骨损伤评分及滑膜炎症程度评分呈负相关(P<0.05),与年龄无相关性(P>0.05),但122例总体分析,关节液HA含量与年龄呈负相关关系且有性别差异(P<0.05)。软骨损伤对血清HA和关节液HA含量的影响比滑膜炎大。结论:血清和关节液HA可作为生物学标志物反映软骨损伤程度和滑膜炎程度,血清HA含量升高及关节液HA含量降低提示软骨损伤及滑膜炎程度较重。

Objective：To explore the relationship between the contents of hyaluronic acid level in serum and synovial fluid and the osteoarthritis lesion degree in patients with osteoarthritis. Methods：The contents of hyaluronic acid level in serum and synovial fluid of 128 knees in 122 patients with knee joint diseases were measured with enzyme-linked immunosorbent assay （ELISA） and the degrees of cartilage injury and synovial inflammation were assessed. Results： The contents of serum hyaluronic acid level, cartilage injury scores and synovitis scores in osteoarthritis group were higher than those in non-osteoarthritis group （P 〈0.01 ）, but the contents of hyaluronie acid level in synovial fluid were lower than those in non-osteoarthritis group （ P 〈 0.01 ）. The contents of hyaluronic acid level in serum in osteoarthritis group correlated positively with years, cartilage injury scores and synovitis scores （P 〈 0.05 ） , and no difference in gender （P 〉 0.05）. The contents of hyaluronic acid level in synovial fluid correlated negatively with cartilage injury scores and synovitis scores （ P 〈 0.05 ）, and no correlation with years （ P 〉 0.05 ）. But the contents of hyaluronic acid level in syno- vial fluid among 122 patients correlated negatively with years and had difference in gender （P 〈 0.05）. The effect of cartilage injury to the hyaluronic acid level in serum and synovial fluid was more significant than that of synovitis. Con- clusions ： The hyaluronic acid level in serum and synovial fluid of knees may used as a biomarker to reflect the degree of cartilage injury and synovitis. That the contents of hyaluronic acid level in serum increase or the contents of hyaluronic acid level in synovial fluid decrease suggests that the degrees of cartilage injury and synovial inflammation may be more seventy.