腓骨近端截骨术治疗内侧间室膝骨关节炎术后白介素-17水平变化研究

Change of interleukin-17 levels in both synovial fluid and serum of patients with medial compartment knee osteoarthritis after proximal fibular osteotomy

目的探讨腓骨近端截骨术治疗内侧间室膝骨关节炎(KOA)患者术后血清和关节滑液中白介素-17(IL-17)的水平变化。方法选择2014年12月~2015年6月因内侧间室KOA于沧州市中心医院接受腓骨近端截骨术治疗的30例患者作为试验组,另外选择30例膝关节正常自愿者作为对照组。试验组术后采用膝关节学会评分系统(KSS)评价膝关节功能,视觉模拟疼痛评分(VAS)评价膝关节疼痛程度。术前及术后6、12、18个月抽取肘部静脉血液以及患侧膝关节滑液,采用ELISA检测试剂盒测量血清及关节滑液IL-17含量,对照组抽取肘部静脉血进行相应检测并比较。结果试验组患者术后切口均I期愈合;均获至少18个月随访。断端愈合后测量股胫角平均为(168.6±3.4)°。试验组术后VAS评分和KSS评分较术前均有显著改善,差异有统计学意义(P<0.05);术后各时间点间比较,差异无统计学意义(P>0.05)。与对照组比较,试验组术前血清IL-17含量显著增高,差异均有统计学意义(P<0.05);试验组血清及关节滑液IL-17含量在术后各时间点均较术前显著降低(P<0.05),但血清IL-17含量均高于对照组水平(P<0.05)。术后各时间点血清及关节滑液IL-17比较,差异无统计学意义(P>0.05)。结论腓骨近端截骨术可显著改善内侧间室KOA患者的疼痛症状和关节功能,并可在一定程度上降低患者体内IL-17水平,但不能恢复至健康人水平。

Objective To investigate interleukin-17（IL-17） levels in both synovial fluid and serum of patients with medial compartment knee osteoarthritis（KOA） after proximal fibular osteotomy. Methods Thirty patients with medial compartment KOA underwent proximal fibular osteotomy at the Cangzhou Central Hospital from December 2014 to June2015 were selected as experimental group, and 30 healthy individuals were selected as control group into the study.Visual analog pain score（VAS） and Knee Society score（KSS） were used to evaluate pain level and function of the experimental group. The IL-17 levels in both serum and synovial fluid of the experimental group at preoperative period and postoperative 6, 12, 18 months were measured by ELISA, also the serum levels of IL-17 in the control group were measured by ELISA. Results All incisions were healed in phase I. And all patients were followed up at least 18 months. The average tibiofemoral angle was（168.6±3.4）°at 18 months after surgery. Average postoperati ve VAS pain and KSS scores were significantly improved compared with preoperative period（P〈0.05）, while there were no statistically significant differences during postoperative points（P〈0.05）.The serum levels of IL-17 in the experimental group at different time points were higher than that in the control group（P〈0.05）. The IL-17 levels in both serum and synovial fluid of the experimental group during postoperative points were decreased compared with preoperative period（P〈0.05）, while there were no statistically significant differences during postoperative points（P〈0.05）. Conclusion Proximal fibular osteotomy can significantly improve the pain symptoms and joint function of the patients with medial compartment KOA. It also can reduce the IL-17 levels in both synovial fluid and serum, while which can not back to healthy level.