早期关节腔内注射透明质酸对老年关节创伤后患者软骨细胞凋亡的影响

Influence of intra-articular injection of hyaluronic acid at early stage on articular cartilage cells apoptosis in elderly patients with articular injury

目的 探讨早期关节腔内注射透明质酸对老年关节创伤后关节软骨细胞凋亡的影响.方法 选择2013年1月至2014年10月我院收治的89例老年关节创伤患者为研究对象,采用随机数字表法分为对照组40例,采用常规的手术和抗感染治疗;观察组49例,在常规治疗的基础上给予关节腔内注射透明质酸.比较分析两组软骨细胞凋亡率和细胞周期以及增殖指数. 结果 观察组细胞凋亡率（4.08±0.74）％比对照组（6.41±0.54）％低（t=16.403,P＜0.001）;对照组G0/G1期细胞（91.7±4.3）％高于观察组（83.5±3.5）％（t=10.275,P＜0.001）;对照组S（3.5±0.3）％和G2/M期细胞（4.7±0.6）％以及增殖指数（9.1±1.1）％低于观察组S（8.2±2.4）％和G2/M期细胞（8.5±1.8）％以及增殖指数（16.7±1.9）％（t=12.293、12.731和22.198,均P＜0.001）. 结论 老年关节创伤后,早期关节腔内注射透明质酸可降低细胞凋亡率,有利于关节软骨细胞更替,促进患者康复.

Objective To investigate the influence of intra-articular injection of hyaluronic acid at early stage on articular cartilage cells apoptosis in elderly patients with articular injury.Methods A total of 89 elderly patients with articular injury from Jan.2013 to Oct.2014 were randomly divided into observation group and control group.In control group,40 cases were treated with conventional surgery and anti-inflammatory therapy.In observation group,49 cases were treated intraarticular injection of hyaluronic acid added to conventional therapy.The apoptosis rate of articular cartilage cells,cell cycle and proliferation index were compared between the two groups.Results The apoptosis rate of articular cartilage cells was lower in observation group than in control group [（4.08±0.74）% vs.（6.41±0.54）%,t=16.403,P〈0.001].The ratio of G0/Giin articular cartilage cells was lower in observation group than in control group[（83.5 ± 3.5）% vs.（91.7± 4.3）%,t10.275,P〈0.001].The ratios of S and G2/M and the proliferation index in articular cartilage cells were lower in control group than in observation group[（3.5 ± 0.3）% vs.（8.2± 2.4）%,（4.7±0.6）% vs.（8.5±1.8）% and （9.1±1.1）% vs.（16.7±1.9）%,t=12.293,12.731 and 22.198,respectively,all P〈0.001].Conclusions Intra articular injection of hyaluronic acid at early stage decreases the apoptosis rate of articular cartilage cells,helps articular cartilage cells turnover and improves the recovery of articular injury in elderly patients.