臭氧治疗对膝骨性关节炎关节滑液中高敏C反应蛋白和基质金属蛋白酶3的影响

Influence of ozone therapy on high-sensitivity C-reactive protein and matrix metalloproteinases-3 in synovial fluid of patients with knee osteoarthritis

目的 观察臭氧治疗对膝骨性关节炎患者关节滑液中高敏C反应蛋白（hs-CRP）和基质金属蛋白酶3（MMP-3）的影响,探讨其治疗骨性关节炎的作用机制.方法 将62例膝骨性关节炎患者按随机数字表法分为对照组和观察组,每组31例.对照组给予关节腔内注射玻璃酸钠治疗,观察组给予关节腔内注射医用臭氧治疗,每周1次,连续治疗5次为1个疗程.评价两组临床疗效,并检测治疗前后两组患者关节滑液中hs-CRP和MMP-3水平.结果 观察组总有效率为100.00％（3l/31）,显著高于对照组的87.10％（27/31）,差异有统计学意义（x2=4.28,P＜0.05）.观察组治疗后关节滑液中hs-CRP和MMP-3水平分别为（6.68±2.15） mg/L、（69.84±16.97） μg/L,均明显低于对照组的（8.72 ± 2.39） mg/L、（85.43±19.52） μg/L,差异有统计学意义（t=3.53,3.36,P＜0.01）.结论 臭氧治疗膝骨性关节炎疗效确切,其作用机制可能与其抑制炎性反应、降低关节滑液中MMP-3水平有关.

Objective To explore the influence of ozone therapy on high-sensitivity C-reactive protein （hs-CRP） and matrix metalloproteinases-3 （MMP-3） in synovial fluid of patients with knee osteoarthritis,and to investigate the possible mechanism.Methods Sixty-two patients with knee osteoarthritis were divided into observation group and control group by random digits table method with 31 cases each.The patients of observation group were treated with ozone,while the patients of control group were treated with hyaluronic acid once a week for 5 weeks.The efficacy was evaluated and the level of hs-CRP and MMP-3 in synovial fluid were detected before and after treatment.Results The total effective rate in observation group was 100.00％ （31/31）,significantly higher than that in control group [87.10％ （27/31）],and there was significant difference （x2 =4.28,P ＜ 0.05）.After treatment,the level of hs-CRP and MMP-3 in observation group was （6.68 ±2.15） mg/L,（69.84 ± 16.97） μ g/L,significantly lower than that in control group [（8.72 ± 2.39） mg/L,（85.43 ± 19.52） tμ g/L],and there was significant difference （t =3.53,3.36,P ＜ 0.01）.Conclusion There is significant effect of ozone therapy of patients with knee osteoarthritis,its mechanism may be reducing the level of MMP-3 and inhibiting inflammatory reaction.