透明质酸钠对膝骨性关节炎关节滑液中骨桥蛋白和血管内皮生长因子水平的影响及其意义

The influence and significance of sodium hyaluronate on the OPN and VEGF in the synovia fluid in patients with knee osteoarthritis

目的探讨透明质酸钠对KOA患者关节滑液中OPN和VEGF水平影响及意义。方法选择157例KOA患者,分析关节滑液OPN和VEGF与KOA分级、治疗时间和临床疗效相关性。结果随着KOA加重,关节滑液中OPN和VEGF浓度显著升高,差异有统计学意义（F值分别为336.06、286.63,P〈0.01）;且不同严重程度关节滑液中OPN和VEGF浓度显著正相关（r值为0.748~0.882,P〈0.01）。随着治疗时间的延长,关节滑液中OPN和VEGF的浓度显著降低,差异有统计学意义（F值分别为131.28、251.15,P〈0.01）;关节滑液中OPN和VEGF浓度与治疗时间呈显著正相关（r值分别为0.58、0.72,P〈0.01）。KOA疗效越明显,关节滑液中OPN和VEGF浓度越低,差异有统计学意义（F值分别为129.18、80.63,P〈0.01）。关节滑液中OPN和VEGF浓度与临床疗效呈显著正相关（r值分别为0.78、0.67,P〈0.01）。结论 OPN和VEGF反映KOA严重程度和疗效,透明质酸钠能显著降低OPN和VEGF水平。

Objective Investigate the impaction and significance of sodium hyaluronate on the osteopontin（ OPN） and（ vascular endothelial growth factor） VEGF in the synovia fluid in patients with knee osteoarthritis. Methods 157 cases of knee osteoarthritis（ KOA） were selected,and the correlation of OPN,VEGF and KOA grade,treatment time and clinical curative effect were analyzed. Results With the increase of KOA,the concentrations of OPN and VEGF in the synovia fluid were increased significantly. There were significant difference between them（ F value were 336. 06,286. 63,P 〈0. 01）; the concentrations of OPN and VEGF in the synovia fluid were significantly positively correlated with the degree of severity（ r value were 0. 748-0. 882,P 〈0. 01）. With the expanding of the treatment time,the concentration of OPN and VEGF in the synovia fluid significantly declined and the differences had statistical significance（ F value were 131. 28,251. 15,P〈 0. 01） and there was significant positive correlation between concentration of OPN,VEGF in synovial fluid and the time of treatment（ r value were 0. 58,0. 72,respectively,P〈 0. 01）. The more obvious of the effect of treatment,the lower the concentration of OPN and VEGF in the synovia fluid（ F value were 129. 18,80. 63,respectively,P 〈0. 01）. There were significant positive correlation between the concentration of OPN,VEGF in synovial fluid and the effect of treatment（ r value were 0. 78,0. 67 respectively,P〈 0. 01）. Conclu sion The concentration of OPN and VEGF can reflect the severity and effect of treatment KOA,and sodium hyaluronate can significantly decline the concentration of OPN and VEGF.