骨关节炎动物模型中血清透明质酸的变化及其意义

A study on hyalnronic acid levels predicting the progression of osteoarthritis

目的探讨血清透明质酸在预测骨关节炎病情进展中的价值。方法70只雄性新西兰大白兔随机分成骨关节炎组和对照组，每组35只。骨关节炎组实验兔左膝关节腔注射2％的木瓜蛋白酶0．5ml，建立骨关节炎模型；对照组左膝关节腔注射等量无菌0．9％氯化钠注射液。在建模后第1、2．4，6、8、10、12周分别取实验兔动脉血检测血清透明质酸水平，行磁共振成像（MRI）扫描，取膝关节标本行组织病理学观察。组间采用t检验。结果骨关节炎组出现关节软骨变薄、基质分解破坏、滑膜增生等炎症及退行性改变，并随观察时间的延长而进一步发展；血清透明质酸水平明显升高[12周：骨关节炎组（657±132）ng／ml，对照组（166±8）ng／m1]，与对照组相比差异有统计学意义，结果同MRI所见结构破坏具有相关性。结论血清透明质酸水平对骨关节炎病情的进一步发展具有预测价值。

Objective To study the predictive value of serum hyaluronic acid （HA） levels for morphological progression of osteoarthritis （OA）. Methods Seventy New Zealand white rabbits were randomly and equally divided into the OA group and the normal control group. OA was induced by injecting 0.5 ml of 2% papain into the left knee joints and the same volume of sterile saline solution was injected into right knee joints in control group. The serum HA levels were detected at 1, 2, 4, 6, 8, 10 and 12 weeks!after injection. Then magnetic resonance imaging （MRI） and pathohistological changes were observed. T test was used for the analysis of measurment. Results Compared with the control group, degeneration changes were found in the OA group, such as thinner articular cartilage, fibrillation and destroyed cartilage matrix, and inflammation, proliferation and degeneration of the synovial tissue. All these changes were much worse with prolonged observation time. The serum HA levels were increased [12 week： （657±132） ng/ml, vs （166±8） ng/ml], which correlate with structural damage. Conclusion Serum HA levels had a predictive value for further development of OA.