人尿液中CTX-Ⅱ与Zn^(2+)、Ca^(2+)浓度对膝关节骨关节炎诊断价值的研究

The study of the effect of type Ⅱ collagen and Zn^(2+),Ca^(2+) in the human urine on the diagnosis of knee osteoarthritis

目的探讨膝关节骨关节炎(KOA)患者尿液中CTX-Ⅱ与Zn2+、Ca2+浓度与其病变程度的关系。方法收集82例KOA组和20例对照组的尿液标本及膝关节正侧位影像学资料,采用Kellgren-Lawrence放射学分级标准对KOA组的影像学表现分级,分为I级组、II级组、III级组及IV级组。采用酶联免疫吸附试验(ELISA)检测尿液中CTX-Ⅱ、ICP-AES测定Zn2+、Ca2+浓度。结果 KOA组尿液中CTX-Ⅱ与Zn2+、Ca2+浓度高于对照组(P<0.001)。CTX-Ⅱ水平:IV组>III组>II组>I组和对照组(P=0.000)。Zn2+、Ca2+浓度:IV组、III组、II组、I组>对照组(P=0.000)。结论 CTX-Ⅱ升高水平与KOA的影像学分级平行,两者呈高度正相关性。Zn2+、Ca2+升高水平与KOA的影像学分级并不平行。CTX-Ⅱ可作为区分KOA严重程度的标志物,但其作为早期诊断的价值有限,但与Zn2+、Ca2+联合有望成为KOA的早期诊断指标。

Objective To discuss the relationship between the concentration of CTX-II,Zn2 ＋,and Ca2 ＋in urine and the severity of knee osteoarthritis（ KOA）. Me thods Eighty-two patients with KOA were chosen as KOA group,and twenty healthy volunteers were selected as control group. Urine and anteroposterior and lateral position X-ray films of the knee joint were collected.The images were classified according to Kellgren-Lawrence radiographic grading criterion. The patients were divided into grade I group,grade II group,grade III group,and grade IV group. The concentration of CTX-II in the urine was detected using enzymelinked immunosorbent assay（ ELISA）. The concentrations of Zn2 ＋and Ca2 ＋in urine were detected using inductively coupled plasma atomic emission spectrometry（ ICP-AES）. Re sults The concentrations of CTX-II,Zn2 ＋,and Ca2 ＋in KOA group were significantly higher than those in control group（ P〈0. 001）,in a grade-dependent manner（ group IV〉 group III〉 group II〉 group I 〉control group. Conclusion The increase of CTX-II is paralleled with the grade in X-ray image. They are highly correlated. The increase of Zn2 ＋and Ca2 ＋is not paralleled with the grade in X-ray image. CTX-II is a marker for the progress of KOA,but it has little help for early diagnosis for KOA. However,CTX-II combines with Zn2 ＋and Ca2 ＋may be helpful for the early diagnosis for KOA.