联合检测血清软骨寡聚基质蛋白和硫酸软骨素-846在膝骨关节炎早期诊断中的作用研究

Correlation between serum cartilage oligomerie matrix protein and chondroitin sulfate-846 and clinical symptoms and imaging manifestations in patients with knee osteoarthritis and the roles in early diagnosis

目的检测初诊无伴发疾病的膝骨关节炎患者血清软骨寡聚基质蛋白(COMP)和硫酸软骨素846(CS-846)水平,及其与疼痛视觉模拟评分(VAS)和关节间隙狭窄程度之间的相关性,探讨血清COMP和CS-846在膝骨关节炎早期诊断中的作用。方法按世界卫生组织(WHO)社区控制风湿病规划(COPCORD)程序在山西省进行骨关节炎流行病学调查,在确诊骨关节炎患者中选取50例膝骨关节炎患者进行生物学标志物监测。采用t检验对2组患者COMP、CS-846含量进行比较;采用相关分析对生物学标志物水平与VAS评分和关节间隙狭窄的相关性进行分析。结果膝骨关节炎组血清COMP[男性(521±73)ng/L,女性(598±95)ng/L]、CS-846含量[男性(423±23)ng/L,女性(476±46)ng/L]明显高于对照组,差异均有统计学意义;血清COMP水平与关节间隙狭窄程度之间存在相关性(r=0.216,P=0.039);血清CS-846水平与疼痛VAS评分(r=0.334,P=0.027)及关节间隙狭窄程度存在相关性(r=0.415,P<0.001)。结论血清COMP和CS-846与膝骨关节炎患者VAS评分和关节间隙狭窄程度之间具有相关性,联合检测血清COMP和CS-846在膝骨关节炎早期诊断中具有一定的临床价值。

Objective To determine the levels of serum cartilage oligomerie matrix protein （COMP） and chon- droitin sulfate 846 （CS-846） and to examine their correlation with VAS score and the magnitude of joint space narrow- ing, thus investigating the roles of measuring serum COMP and CS-846 in the early diagnosis of knee osteoarthritis. Methods Based on the community oriented program from control of rheumatic diseases （COPCORD） proposed by World Health Organization, an epidemiological study was conducted in patients with osteoarthritis from Shanxi province. Fifty cases with physician-confirmed knee osteoarthritis were randomly selected for biological markers moni- toring. T-tests were adopted to statistically compare the levels of serum COMP and CS-846. Correlation analysis was employed to evaluate the correlation between biological markers and VAS scores and joint space narrowing （JSN）. Results The levels of serum COMP [（521±73） ng/L for males vs. （598±95） ng/L for females] and CS-846 level （423±23 ng/L for males; 476_＋46 ng/L for females） were significantly higher than those in control group （both P〈0.05）. Serum COMP was positively correlated with the magnitude of JSN （r=0.216, P=0.039）, which was positively correlated with serum CS-846 and VAS score （r=0.415, P〈0.001）. Conclusion Serum COMP and CS-846 correlate with VAS score and the magnitude of JSN in patients with osteoarthritis, indicating that their combination may be worthwhile for the early diagnosis of knee osteoarthritis.