痛风性关节炎与骨关节炎的相关性研究

Research on the Correlation of Gouty Arthritis with Osteoarthritis

目的:通过检测痛风性关节炎与骨关节炎患者膝关节液中Ⅱ型胶原羧基端端肽(C-telopeptide of type II collagen,CTX-Ⅱ)的含量,探讨痛风性关节炎与骨关节炎的相关性。方法:收集膝关节发作的痛风性关节炎患者膝关节液标本46例及骨关节炎患者膝关节液标本42例,用酶联免疫吸附试验(ELISA)法检测两组关节液中CTX-Ⅱ的含量,并研究分析痛风性关节炎膝关节液中CTX-Ⅱ的含量与影像学X线特征、单钠尿酸盐(MSU)晶体的相关性。结果:1痛风性关节炎与骨关节炎的膝关节液中CTX-Ⅱ的含量相比较无统计学差异(P=0.40);245.7%(21/46)的痛风性关节炎患者膝关节X线显示骨关节炎,与膝关节X线未显示骨关节炎的痛风性关节炎(25/46)相比较,两组CTX-Ⅱ的含量无统计学差异(P=0.84);3MSU晶体阳性的痛风性关节炎(19/46,41.3%)与MSU晶体阴性的痛风性关节炎(37/46,68.7%)患者的膝关节液CTX-Ⅱ的含量比较,前者显著高于后者,差异有统计学意义(P<0.05)。结论:痛风性关节炎的受累关节存在关节软骨的退变,单钠尿酸盐(MSU)晶体在局部沉积与否与关节软骨退变的程度相关。

Objective： To explore the correlation of gouty arthritis with osteoarthritis through determining the content of C-telopeptide of type Ⅱ collagen （CTX—Ⅱ） in the synovial fluid. Methods： A group of 46 patients with gouty arthritis and a group of 42 patients with osteoarthritis were included in the study. The synovial fluid from all patients was obtained through keen joint puncturing. The content of CTX—Ⅱ in the synovial fluid was determined by Enzyme-linked immunosorbent assay （ELISA）. Further to analyze the correlation of the content of CTX—Ⅱ in the synovial fluid from gouty arthritis patients with X-ray features of gouty arthritis and monosodium urate （MSU） crystals. Results： There was no statistical difference in the content of CTX—Ⅱ between gouty arthritis group and osteoarthritis group （P=0.40）; 45.7% （21/46） of gouty arthritis showed X-ray knee osteoarthritis. Comparing with gouty arthritis with negative X-ray knee osteoarthritis （25/46）, there was no statistical difference between the two groups （P= 0.84）; MSU crystals were observed in 41.3% （19/46） of gouty arthritis under a polarization microscope. Comparing with gouty arthritis of negative M SU crystal. The content of CTX—Ⅱ in the former was significantly higher than that in the latter. There was significant difference in the content of CTX—Ⅱ between the two groups （P〈0.05）. Conclusion： The joint attacked by gouty arthritis occurs cartilage degeneration and whether MSU crystals locally deposit is associated with the degree of cartilage degeneration.