膝骨关节炎患者关节液和滑膜中IL-6、MMP-13、VEGF的表达及与病情进展的关系

Expression of IL-6, MMP-13, VEGF in Synovial Fluid and Synovial Membrane of Patients with Knee Osteoarthritis and Their Relationship with the Progression of the Disease

目的:研究膝骨关节炎(KOA)患者关节液和滑膜中白细胞介素-6(IL-6)、基质金属蛋白酶-13(MMP-13)、血管内皮生长因子(VEGF)的表达及与病情进展的关系。方法:选择自2017年1月到2017年6月在我院就诊的KOA患者30例进行研究,其中维吾尔族和汉族各15例,分别记为维吾尔族组和汉族组。另选同期在我院接受骨折修复和截肢等手术治疗的10例无骨关节炎的患者作为对照组。对比各组IL-6、MMP-13及VEGF水平以及关节软骨中水通道蛋白3(AQP3)阳性表达率,对比维吾尔族组和汉族组软骨不同区域内AQP3阳性表达,分析KOA患者关节液和滑膜中IL-6、MMP-13、VEGF及关节软骨中AQP3的阳性表达与病情进展的相关性。结果:维吾尔族组和汉族组关节液和滑膜中IL-6、MMP-13及VEGF水平均分别高于对照组,差异均有统计学意义(均P<0.05)。维吾尔族组和汉族组关节软骨中AQP3阳性表达率均分别明显高于对照组,且维吾尔族组明显高于汉族组,差异均有统计学意义(均P<0.05)。维吾尔族组和汉族组浅层软骨磨损严重区的AQP3阳性表达率明显高于软骨深层区和软骨下骨区,差异均有统计学意义(均P<0.05)。Spearman相关性分析显示,KOA患者关节液和滑膜中IL-6、MMP-13、VEGF及关节软骨中AQP3的阳性表达与病情进展均呈正相关(均P<0.05)。结论:KOA患者关节液和滑膜中IL-6、MMP-13、VEGF水平及关节软骨中AQP3阳性表达均异常升高,以上指标参与了病情的进展,且AQP3阳性表达高低还与民族有关,临床上可考虑将这些指标作为监测KOA患者病情的靶点。

Objective： To investigate the expression of interleukin -6 （IL-6）, matrix metalloproteinase -13 （MMP-13）, vascular endothelial growth factor （VEGF） in synovial fluid and synovial fluid of patients with knee osteoarthritis （KOA） and their relationship with the progression of the disease. Methods： 30 patients with KOA in our hospital were enrolled in this study from January 2017 to July 2017, of whom had each 15 cases in Uygur and Hart respectively, and Uygur group and Hart group were recorded. 10 patients without osteoarthritis who underwent fracture repair and amputation and other surgical treatment in our hospital were selected as the control group at the same time. The levels oflL-6, MMP-13 and VEGF in each group and the expression rate of aquaporin 3 （AQP3） in articular cartilage were compared, the positive expression of AQP3 in different regions of cartilage in Uygur and Han groups was compared, the expression of IL-6, MMP-13, VEGF and the positive expression of AQP3 in articular cartilage and the progression of disease in synovial fluid and synovial membrane of patients with KOA were analyzed. Results： The levels of IL-6, MMP-13 and VEGF in the synovial fluid and synovial membrane of the Uygur group and Han group were higher than those of the control group, the differences were statistically significant （P〈0.05）. The positive expression rate of AQP3 in the joint cartilage of the Uygnr group and Han group was significantly higher than that in the control group, and the Uygur group was significantly higher than the Han group, the difference was statistically significant （P〈0.05）. The positive expression rate of AQP3 in the superficial cartilage area was significantly higher than that in the deep and subchondral regions in the Uygur group and Han group, the differences were statistically significant （P〈0.05）. The positive expression of IL-6, MMP-13, VEGF and AQP3 in articular cartilage and synovial fluid and synovial fluid of patients with KOA were positively eorre-lated with the progression of the disease （P〈0.05）. Conclusion： The levels oflL-6, MMP-13, VEGF and the positive expression of AQP3 in articular cartilage in synovial fluid and synovial membrane of KOA patients were abnormally elevated, the above indicators participated in the progress of the disease, and the positive expression of AQP3 is also related to the nation, which may be considered as a target for monitoring the patient＇s condition in KOA.