血浆及关节滑液中结缔组织生长因子水平与膝关节骨性关节炎严重程度的相关性

Correlations between connective tissue growth factor levels in plasma and synovial fluid and disease severity of primary knee osteoarthritis

目的测定原发性膝关节骨性关节炎(OA)患者血浆和关节滑液中结缔组织生长因子(CTGF)水平,探讨CTGF与膝关节OA严重程度的相关性。方法选择原发性膝关节OA患者75例为研究组,男25例,女50例,平均年龄(68.9±8.1)岁;采用Kellgren-Lawrence分级系统(KL分级)进行分级,研究组患者的膝关节X线片评价至少为KL 2级。对照组为排除膝关节OA的健康人25例,其髋、膝关节X线片评价均为KL 0级,男8例,女17例,平均年龄(67.8±7.5)岁。研究组与对照组性别、年龄、体质量指数差异均无统计学意义(P>0.05)。采用酶联免疫吸附测定法测定2组血浆和滑液中CTGF水平,分析研究组血浆和关节滑液中CTGF水平与KL分级的相关性。结果研究组血浆CTGF水平显著高于对照组,研究组关节滑液中CTGF水平显著高于血浆,差异均有统计学意义(P<0.05)。不同KL分级亚组间的血浆和关节滑液中CTGF水平比较差异均有统计学意义(P<0.05),KL分级越高,血浆和滑液中CTGF水平越高。血浆和关节滑液中CTGF水平与OA严重程度的KL分级呈显著正相关(P<0.05)。结论血浆和关节滑液中CTGF水平与OA患者影像学严重程度呈正相关,CTGF可作为反映膝关节OA严重程度和疾病进展情况的标志物。

Objective To determine the plasma and synovial fluid connective tissue growth factor（CTGF） levels in patients with primary knee osteoarthritis（OA） in order to investigate the correlations between CTGF levels and severity level of OA.Methods Seventy-five patients with primary knee OA were selected as research group with 25 males and 50 females,whose mean age was（68.9±8.1） years.Knee OA grading was performed according to the Kellgren–Lawrence（KL） classification.OA patients were defined as having radiographic knee OA of KL grade 2 at least.Twenty-five healthy people（8 males and 17 females）with normal knee radiographs as control group,whose mean age was（67.8±7.5）years and with radiographic knee OA of KL grade 0.There was no significant difference of sex,age and body mass index between the 2 groups.The plasma and synovial fluid CTGF levels were determined by enzyme-linked immunosorbent assay.Correlations between plasma and synovial fluid CTGF levels and severity level of OA were calculated.Results The plasma level of CTGF in research group was higher significantly than that in control group,and the synovial fluid level of CTGF was higher significantly than the plasma level in research group,the differences were both significant（P0.05）.There were significant difference of CTGF levels in plasma and synovial fluid among the different KL grade subgroup（P0.05）,and the levels were increasing with the severity grade of KL increased.Both plasma and synovial fluid CTGF levels were positively correlated with the severity grade of KL for knee OA（P0.05）.Conclusion Both plasma and synovial fluid CTGF levels are positively correlated with the degree of radiographic severity in patients with primary knee OA.CTGF may be an useful biochemical markers to reflect the disease severity and progression of knee OA.