关节镜清理联合玻璃酸钠关节腔注射对膝骨关节炎患者关节液Wnt/β-catenin通路的影响

Effect of arthroscopic debridement combined with intra-articular sodium hyaluronate injection on the Wnt/β-catenin pathway in joint fluid of patients with knee osteoarthritis

目的:关节镜清理联合玻璃酸钠关节腔注射治疗对膝骨关节炎患者关节液中Wnt/β-catenin通路的影响。方法:选择2014年6月~2017年4月期间因膝骨关节炎在我院接受关节镜清理手术的患者作为研究对象,随机分为接受关节镜清理联合玻璃酸钠关节腔注射治疗的观察组以及单纯接受关节镜清理手术的对照组。手术前及手术后7d时,测定关节液中Wnt/β-catenin通路分子及下游胶原代谢分子、骨代谢分子。结果:手术后7d时,两组患者关节液中Wnt1、Wnt5a、Wnt7b、β-catenin、MMP1、MMP13、CTX-I、CTX-Ⅱ、ADAMTS4、ADAMTS5、RANK、RANKL、TRACP5b的mRNA表达量均高于手术前,OPG、OC的含量低于手术前且观察组患者关节液中Wnt1、Wnt5a、Wnt7b、β-catenin、MMP1、MMP13、CTX-I、CTX-Ⅱ、ADAMTS4、ADAMTS5、RANK、RANKL、TRACP5b的mRNA表达量显著低于对照组,OPG、OC的含量显著高于对照组。差异均有统计学意义(P<0.05)。结论:关节镜清理联合玻璃酸钠关节腔注射治疗能够抑制手术后Wnt/β-catenin通路所介导的胶原代谢及骨代谢异常。

Objective:To investigate the effect of arthroscopic debridement combined with intra-articular sodium hyaluronate injection on the Wnt/β-catenin pathway in joint fluid of patients with knee osteoarthritis.Methods:Patients undergoing arthroscopic debridement for knee osteoarthritis in the hospital between June 2014 and April 2017 were selected as the research subjects and randomly divided into the observation group who accepted arthroscopic debridement combined with intra-articular sodium hyaluronate injection and the control group who accepted arthroscopic debridement alone.The Wnt/β-catenin pathway molecules as well as downstream collagen metabolism molecules and bone metabolism molecules in the joint fluid were measured before surgery and 7 days after surgery.Results:7 days after surgery,Wnt1,Wnt5 a,Wnt7 b,β-catenin,MMP1,MMP13,CTX-I,CTX-II,ADAMTS4,ADAMTS5,RANK,RANKL and TRACP5 bmRNA expression in joint fluid of bothgroups of patients were higher than those before surgery whereas OPG and OC contents were lower than those before surgery,and Wnt1,Wnt5 a,Wnt7 b,β-catenin,MMP1,MMP13,CTX-I,CTX-II,ADAMTS4,ADAMTS5,RANK,RANKL and TRACP5 bmRNA expression in joint fluid of observation group were significantly lower than those of control group whereas OPG and OC contents were significantly higher than those of control group.Conclusion:arthroscopic debridement combined with intra-articular sodium hyaluronate injection can inhibit the collagen metabolism and bone metabolism disorder mediated by Wnt/β-catenin after surgery.