医用臭氧对骨关节炎患者血清中聚蛋白多糖酶的影响

INFLUENCE OF OZONE ON SERUM AGGRECANASE IN PAIENTS WITH OSTEOARTHRITIS

目的：探讨臭氧对中晚期骨关节炎（osteoarthritis,OA）患者关节软骨中聚蛋白多糖酶1（aggrecanase-1,Agase-1 or ADAMTS-4）及基质金属蛋白酶组织抑制因子（tissue inhibitor of metallopmteinase3,TIMP-3）的影响.方法：21例拟接受全膝关节置换术的单关节OA患者为实验组,入院后于手术前接受30％医用臭氧关节腔注射1～2次,间隔3d至术前;另选入院后接受全膝关节置换术的单关节OA而不进行术前臭氧关节腔注射的患者作为空白对照组（18例）.应用酶联免疫吸附试验（enzyme linked immunosorbent assay,ELISA）检测Agase 1、TIMP-3在两组血清中的表达,以浓度ng/ml表示各项在血清中水平.甲苯胺蓝法检测关节软骨中蛋白多糖（proteoglycan,PG）的含量.结果：与对照组相比,实验组Agase-1表达水平明显下降、TIMP-3明显增加（P＜0.05）,但关节软骨中的蛋白多糖含量增加不明显.结论：臭氧可以抑制Agase 1的表达、增加TIMP-3的表达,但并不改变OA患者关节软骨中蛋白多糖的含量,未见明显的关节保护作用.

Objective：To study the influence of ozone （O3） on the expression of aggrecanase-1 （Agase-1） and tissue inhibitor of metalloproteinase-3 （TIMP-3） in serum of middle-late term osteoarthritis （OA） patients.Methods：A total of 39 cases were divided into the ozone-treated group （n =21） in which patients received total knee replacement surgery with ozone injection before surgery and the blank control group （n =18） in which patients received total knee replacement surgery without ozone injection.Ozone was given by knee joint cavity paracentesis once or twice before operation after hospital admission.Expression of Agase-1 and TIMP-3 in serum of the two groups were investigated by enzyme-linked immunosorbent assay （ELISA） and represented by the concentration unit ng/ml.Contents of proteoglycan （PG） in cartilage were determined by toluidine blue method.Results：Compared to the control group,the serum levels of Agase-1 in the ozone-treated group significantly decreased,and the levels of TIMP-3 significantly increased （P ＜ 0.05）,while the increase in PG in cartilage was not significant.Conclusion：Ozone can suppress Agase-1 and up-regulate TIMP-3 in cartilage in OA patients,but did not change the contents of PG.Ozone has no chondroprotective effect.