EMMPRIN、Caspase-3表达水平与髋关节置换术后人工关节无菌性松动的关系

Relationship between expression of extracellular matrix metalloproteinase inducer,Caspase-3 and aseptic loosening of artificial joint after hip replacement

目的：研究金属蛋白酶诱导因子（EMMPRIN）以及含半胱氨酸的天冬氨酸蛋白水解酶3（Caspase-3）表达水平与髋关节置换术后人工关节无菌性松动的关系。方法：将2001年1月~2004年5月在我院接受人工髋关节置换术的患者纳入研究,采用免疫组化方法检测关节滑膜组织中EMMPRIN、Caspase-3的表达情况,并随访手术后人工关节无菌性松动的发生情况。结果：（1）EMMPRIN阳性率47.25%、Caspase-3阳性率48.5%,5年人工关节无菌性松动率11.25%,10年松动率17.25%;（2）单因素分析结果显示关节滑膜中EMMPRIN、Caspase-3阳性表达患者的人工关节5、10年松动率均高于阴性表达患者（P〈0.05）;（3）logistic回归分析显示EMMPRIN、Caspase-3阳性表达是人工关节无菌性松动的危险因素。结论：关节滑膜中EMMPRIN、Caspase-3阳性表达是髋关节置换术后发生人工关节无菌性松动的危险因素,而抑制EMMPRIN、Caspase-3可能成为预防无菌性松动的治疗靶点。

Objective：To study the relationship between the expression of extracellular matrix metalloproteinase inducer,Caspase-3and aseptic loosening of artificial joint after hip replacement.Methods：Patients received hip replacement in our hospital from 2001 January to 2004 May were enrolled.Expressions of EMMPRIN,Caspase-3in synovial tissue were detected by immunohistochemical methods and the occurrence of artificial joint aseptic loosening after hip replacement were followed up.Results：The positive rate of Caspase-3and EMMPRIN were 47.25% and 48.5%,separately;five years loose rate and ten years loose rate were 11.25%and 17.25%,separately.Single factor analysis showed that five years loose rate and ten years loose rate of EMMPRIN,Caspase-3positive expressed patients were higher than those of negative patients（P〈0.05）.Logistic regression analysis showed that the positive expression of EMMPRIN,Caspase-3were risk factors of a artificial joint septic loosening after hip replacement.Conclusion：Positive expression of EMMPRIN,Caspase-3in synovial tissue are risk factors of artificial joint aseptic loosening after hip replacement.EMMPRIN,Caspase-3are a therapeutic targets for preventing aseptic loosening.