运动疗法对膝骨性关节炎患者关节滑液中细胞因子的影响

Effect of Exercise Therapy on the Levels of Cytokines in Joint Synovial of Patients with Knee Osteoarthritis

目的:观察运动疗法对膝骨性关节炎(KOA)患者关节滑液中细胞因子肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)和基质金属蛋白酶-3(MMP-3)含量的影响,探讨其治疗骨性关节炎的作用机制。方法:选择KOA患者80例,随机分为治疗组和对照组,各40例,治疗组患者口服双氯芬酸钠,同时进行运动疗法治疗;对照组患者口服双氯芬酸钠治疗,治疗4周。分别于治疗前后检测两组患者膝关节滑液中TNF-α、hs-CRP和MMP-3的含量。结果:治疗后,两组患者膝关节滑液中TNF-α、hs-CRP和MMP-3水平均较治疗前显著下降(P<0.01)。治疗组患者膝关节滑液中TNF-α、hs-CRP和MMP-3含量均明显低于对照组,差异有统计学意义(P<0.05或P<0.01)。结论:运动疗法能够降低KOA患者关节滑液中TNF-α、hs-CRP和MMP-3的水平,抑制炎症因子对关节软骨的破坏,从而延缓关节软骨退变的进程。

Objective: To investigate the effect of exercise therapy on the levels of TNF-α、hs-CRP and MMP-3 in joint synovial of patients with knee osteoarthritis(KOA).Methods: Eighty patients with knee osteoarthritis were randomly divided into the control group(n=40) treated with diclofenac sodium and the treatment group(n=40) treated with diclofenac sodium combined with exercise therapy for 4 weeks.The levels of TNF-α、hs-CRP and MMP-3 in joint synovial were determined before and after treatment.Results: The levels of TNF-α、hs-CRP and MMP-3 after treatment in synovial fluid significantly lower than those before treatment in the two groups.However,the levels of TNF-α、hs-CRP and MMP-3 in the treatment group were lower than those in the control group after treatment(P<0.05 or P<0.01).Conclusions: Exercise therapy may be beneficial in thetreatment of osteoarthritis by adjusting the level of TNF-α、hs-CRP and MMP-3 and inhibiting inflammatory reaction.