骨关节炎髌下脂肪垫与软骨缺损的相关性研究

Association between infrapatellar fat pad and cartilage defects in patients with osteoarthritis

目的 探讨膝骨关节炎（ OA ）患者髌骨下脂肪垫（ IPFP）大小与软骨缺损之间的关系. 方法 收集174例膝OA患者,对患者一般情况行问卷调查,在核磁共振3D脂肪抑制T1加权回波序列上利用Osirix软件测量IPFP容积,在核磁共振T2加权质子密度加权快速自旋回波序列上对软骨缺损进行评级（0-4级）,分析IPFP容积与软骨缺损之间的关系. 结果 放射性OA与非放射性OA患者IPFP体积差异无统计学意义;不同严重程度OA患者的IPFP体积差异有统计学意义（P〈0. 05）;OA患者IPFP体积与性别呈负相关性,与身高、体重呈正相关性,差异有统计学意义（P 〈0. 05）;IPFP体积与膝关节内外侧股骨、外侧胫骨以及髌骨软骨缺损呈负相关性,差异有统计学意义（ P〈0. 05 ）. 结论IPFP体积与软骨缺损及OA的病情严重程度相关, IPFP在OA发生发展中可能起保护作用.

Objective To examine the association between infrapatellar fat pad （ IPFP） volume and cartilage de-fects in patients with knee osteoarthritis （ OA） . Methods 174 subjects participated in this study. The fat sup-pressed 3-dimensional T1-weighted spoiled gradient recall （ SPGR） magnetic resonance imaging （ MRI） was used to measure IPFP volume. T2-weighted fast spin echo MRI was utilized to assess cartilage defects. Results There was no significant difference in IPFP volume between patients with radiographic osteoarthritis and those without radio-graphic osteoarthritis. There were significant differences in IPFP volume among groups with mild, moderate and severe diseased groups （ P〈0. 05 ） . IPFP volume was significantly and positively associated with height and weight （ P〈0. 05 ） , and men had more IPFP volume than women （ P〈0. 05 ） . There were significant and negative associ-ations between IPFP volume and cartilage defects at all sites except for medial tibial site （ P〈0. 05 ） . Conclusion IPFP volume is negatively associated with cartilage defects severity in knee OA, suggesting that infrapatellar fat pad may play a protective role in knee OA.