膝骨性关节炎患者血清和关节液FGF-21与IL-1及TNF-a水平的变化及意义

Changes and clinical significances of levels of FGF-21, IL-1, and TNF-a in serum and synovial fluid in patients with knee osteoarthritis

目的探讨膝骨关节炎（Knee osteoarthritis，KOA）患者血清、关节液中成纤维细胞生长因子-21（Fibroblast growth factor 21，FGF-21）、白介素-1（interleukin-1，IL-1）、肿瘤坏死因子-a（tumor necrosis factor-a，TNF-a）的水平变化情况，阐述其在膝骨关节炎发病过程中的作用。方法采用酶联免疫吸附测定法（Enzyme-linked immunosorbent assay，ELISA）检测2013年3月至2015年12月本院门诊及住院部诊治的97例膝骨关节炎患者血清、关节液中FGF-21、IL-1、TNF-a的含量。其中，97例KOA患者依据膝关节X线的Kellgren ＆ Lawrence（K-L）分级，分为对照组（KOA 0级，n=18）和实验组（KOA 1，n=20；KOA 2，n=20；KOA 3，n=19；KOA 4，n=20）。结果与对照组血清FGF-21水平[（323.15±97.63）pg/ml]相比较，实验组各组血清FGF-21水平变化不大，差异无统计学意义（均P〉0.05）。实验组各组间血清IL-1、TNF-a水平随着膝骨关节炎疾病进程，浓度逐渐增大，差异有统计学意义（均P〈0.05）。与对照组关节液FGF-21水平[（198.23±65.41）pg/ml]、IL-1水平[（36.17±6.89）pg/ml]、TNF-a水平[（18.94±5.81）pg/ml]相比较，实验组各组关节液FGF-21、IL-1、TNF-a水平随着膝骨关节炎疾病进程，浓度逐渐增大，差异有统计学意义（均P〈0.05）。相关性分析结果表明，血清IL-1、TNF-a水平与K-L分级呈现正相关（相关系数r=0.899、0.942，P〈0.05），而血清FGF-21与K-L分级呈现负相关（相关系数r=-0.121，P〉0.05）。关节液FGF-21、IL-1、TNF-a水平与K-L分级均呈现正相关（相关系数r=0.876、0.941、0.916，P〈0.05）。结论膝骨关节炎血清及关节液FGF-21、IL-1与TNF-a因子参与膝骨关节炎疾病进程，有一定的参考意义。

ObjectiveTo explore the changes and clinical significances of the levels of FGF-21, IL-1, and TNF-a in the serum and synovial fluid in patients with knee osteoarthritis （KOA）.MethodsThe levels of FGF-21, IL-1β, and TNF-a in the serum and synovial fluid were measured by ELISA in 97 patients with KOA who were divided into a control group （KOA 0, n=18） and an experimental group （KOA 1, n=20; KOA 2, n=20; KOA 3, n=19; KOA 4, n=20） according to Kellgren ＆ Lawrence （K-L） grading.ResultsCompared with the serum level of FGF-21 in the control group [（323.15±97.63） pg/ml], the serum levels of FGF-21 in the KOA 1 - 4 groups changed little, with no statistical differences （all P〉0.05）. Among the KOA 1 - 4 groups, the serum levels and the concentrations of IL-1 and TNF-a increased with KOA disease process, with statistical differences （all P〉0.05）. Compared with the synovial fluid levels of FGF-21 [（198.23±65.41） pg/ml], IL-1 [（36.17±6.89） pg/ml], and TNF-a [（18.94±5.81） pg/ml] in the control group, the synovial fluid levels and the concentrations of FGF-21, IL-1 , and TNF-a in the KOA 1 - 4 groups increased with KOA disease progress, with statistical differences （all P〉0.05）. Correlation analysis showed that the serum levels of IL-1 and TNF-a positively correlated with K-L grading （correlation coefficient r = 0.899 and 0.942, （P〉0.05））, while the serum level of FGF-21 negatively correlated with K-L grading （correlation coefficient r =-0.121, P〉0.05）. The synovial fluid levels of GF-21, IL-1, and TNF-a positively correlated with K-L grading （correlation coefficient r=0.876, 0.941, and 0.916, P〉0.05）.ConclusionThe serum and synovial fluid FGF-21, IL-1 and TNF-a play important roles in KOA disease progress and have certain reference significance.