原发性膝骨关节病中血清相关生物标志物的表达

Serum biomarkers related to primary osteoarthritis

背景:近年来随着分子生物学的不断发展,反映关节软骨早期退变等有关病理变化的实验室指标已是研究的热点问题。目的:探讨C-末段交叉连接的Ⅱ型胶原和软骨寡聚基质蛋白在原发性膝骨关节病患者中的临床意义,寻求原发性膝骨关节病特征规律与C-末段交叉连接的Ⅱ型胶原和软骨寡聚基质蛋白的相关性。方法:纳入膝骨关节病组患者70例,健康志愿者18例设为对照组,采用酶联免疫夹心法检测两组血清中C-末段交叉连接的Ⅱ型胶原和软骨寡聚基质蛋白的水平。结果与结论:原发性膝骨关节病患者血清中C-末段交叉连接的Ⅱ型胶原和软骨寡聚基质蛋白均明显高于对照组,进一步深入研究发现在不同的性别、年龄及X射线的变化中均存在显著性差异,不同中医证型中风寒湿痹型患者C-末段交叉连接的Ⅱ型胶原明显低于肝肾亏虚型和气滞血瘀型患者,而软骨寡聚基质蛋白间比较差异无显著性意义。说明C-末段交叉连接的Ⅱ型胶原和软骨寡聚基质蛋白与膝骨关节炎的发生发展有着密切关系,两者联合应用能显著提高诊断的准确性,在膝骨关节炎的发病机制中具有重要的作用,与软骨的退变密切相关,并且可以反映病情、证型等变化。

BACKGROUND： With the continuous development of the molecular biology, studies on laboratory indicators reflecting the pathological changes of early articular cartilage degeneration have become a hot spot. OBJECTIVE： To explore clinical significance of type Ⅱ collagen telopeptides and cartilage oligomeric matrix protein in knee osteoarthritis patients, seeking the relativity between them and characteristic rule of primary knee osteoarthrosis. METHODS： Seventy patients with primary knee osteoarthrosis were enrolled in the experimental group, and 18 healthy volunteers served as control group. Serum type Ⅱ collagen telopeptides and cartilage oligomeric matrix protein levels were detected by enzyme-linked immunosorbent assay method.RESULTS AND CONCLUSION： The serum type Ⅱ collagen telopeptides and cartilage oligomeric matrix protein levels in the experimental group were significantly higher than those in the control group. There were notable differences among different genders, age and X-ray changes. Stroke musculoskeletal patients with different syndromes of traditional Chinese medicine had lower type Ⅱ collagen telopeptides levels than patients with liver and kidney deficiency as well as vital energy retardation and blood stasis, but no difference was found in cartilage oligomeric matrix protein levels. These findings indicate that type Ⅱ collagen telopeptides and cartilage oligomeric matrix protein have a closely related relationship with the occurrence and development of primary knee osteoarthritis. Combination of type Ⅱ collagen telopeptides and cartilage oligomeric matrix protein can play an important role in the pathogenesis of knee osteoarthritis, have a close relationship with cartilage degeneration and reflect the condition and syndromes of traditional Chinese medicine.