臭氧联合关节镜对膝关节骨关节炎滑膜IL1R Ⅰ、CXCL13与IL24的影响

Effect of ozone combined with arthroscopy on expression of IL1R Ⅰ,CXCL13 and IL24 gene in synovium of osteoarthritis of knee joint

目的观察医用臭氧对膝关节骨关节炎滑膜组织IL1R Ⅰ、CXCL13与IL24的影响。方法 65例(失访11例)膝关节骨关节炎患者,随机分为臭氧联合关节镜治疗组和单纯关节镜治疗组,每组27例,分别于第一次手术及6个月后的第二次手术中切取患者膝关节增生滑膜组织,其中臭氧联合关节镜治疗组关节镜手术后关节腔内注射40μg/mL浓度医用臭氧40 mL/周,共2周;单纯关节镜治疗组术后不注射臭氧,采用反转录PCR法、蛋白印迹法比较两组滑膜治疗前后IL1RⅠ、CXCL13与IL24基因和蛋白表达的差异。结果与单纯关节镜治疗组相比,臭氧联合关节镜治疗组术后滑膜组织IL1R Ⅰ的表达量降低有显著统计学意义(P<0.01);CXCL13的表达量较单纯关节镜治疗组升高有显著统计学意义(P<0.01);IL24 mRNA和蛋白质表达量较关节镜组升高有统计学意义(P<0.05)。结论医用臭氧能通过影响IL1RⅠ、CXCL13与IL24的表达减轻关节炎症状,延缓滑膜炎的进展,臭氧联合关节镜治疗骨关节炎较单纯关节镜清理术临床效果更好,但不能完全阻止和逆转骨关节炎病程进展。

Objective To observe the effect of medical ozone on the expression of IL1R, CXCL-13 and IL24 gene in synovial membrane of osteoarthritis of knee joint. Methods Sixty-five cases of knee osteoarthritis including 11 lost-cases were selected, and randomly divided into combination group and arthroseopy group with 27 cases in each group. After arthroseopie surgery, combination group performed intra-articular injection of 40 μg/mL concentration of medical ozone 40 mL/week for 2 weeks but arthroscopic surgery group had no ozone injection. Differences of the expression of IL1R I, CXCL13 and IL24 gene and protein in synovium were compared before and after the treatment in two groups by RT-PCR and Western blot. Results Expression of IL1R I gene and protein in synovium of combination group was significantly lower than that of arthroscopy group and it showed statistical significance （P 〈 0.01 ）. Expression of CXCL13 gene and IL24 gene and protein in synovium of combination group was higher than those of arthroseopy group and it had statistical significance （P 〈 0.05 ）. Conclusions Medical ozone can reduce the symptoms of arthritis and slow synovitis progress through influencing the expression of IL 1R, CXCL-13 and IL24 gene. The effect of ozone combined with arthroscopic is better than that of simple arthroscopic debridement, but cannot stop and reverse the progression of the disease completely.