膝骨关节炎中医证型与血清Wnt-3α、BMP-2及炎性因子的相关性

Relationship between knee osteoarthritis TCM syndromes and serum Wnt-3α, BMP-2 and inflammatory factors

目的探讨膝骨关节炎中医证型与血清分泌型糖蛋白Wnt-3α、骨形成蛋白-2(BMP-2)及炎性因子的关系。方法选取2016年1月-2017年2月在我院治疗的膝骨关节炎患者174例,其中肝肾阴虚患者36例,脾肾阳虚患者52例,气滞血瘀患者44例,风寒湿痹患者42例,采用实时荧光定量PCR检测血清Wnt-3α和BMP-2表达,采用酶联免疫夹心法检测白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP),采用魏氏法检测红细胞沉降率(ESR)。结果风寒湿痹型患者Wnt-3α和BMP-2表达量分别为(1.95±0.64)和(1.82±0.34),明显高于肝肾阴虚型、脾肾阳虚型和气滞血瘀型患者(P<0.05);风寒湿痹型患者TNF-α表达量为(36.11±8.10)pg/m L,明显高于肝肾阴虚型、脾肾阳虚型和气滞血瘀型患者(P<0.05);各中医证型IL-6、CRP和ESR比较差异无统计学意义(P>0.05)。结论风寒湿痹型患者血清Wnt-3α、BMP-2及TNF-α表达明显升高,而肝肾阴虚型、脾肾阳虚型和气滞血瘀型患者各指标无明显差异。

Objective To investigate the relationship of knee osteoarthritis TCM syndromes and serum glycoprotein Wnt-3α, bone morphogenetic protein-2 （BMP-2） and inflammatory factors. Methods 174 patients with knee osteoarthritis who were treated in our hospital from January 2016 to February 2017 were selected, there were 36 cases of liver and kidney yin deficiency, 52 cases of spleen kidney yang deficiency, 44 cases of stagnation of vital energy and blood stasis, 42 cases of wind-cold-dampness arthralgia. Serum Wnt-3α and BMP-2 expression were detected by real-time quantitative PCR, interleukin -6 （IL-6）, tumor necrosis factor-α（TNF-a） and C reactive protein （CRP） were detected by ELISA, erythrocyte sedimentation rate （ESR） was measured by Westergren method. Results The Wnt-3α and BMP-2 expression in patients with wind-cold-dampness arthralgia were （1.95±0.64） and （1.82±0.34）, which were significantly higher than that of liver and kidney yin deficiency, spleen kidney yang deficiency and stagnation of vital energy and blood stasis （P 〈 0.05）; The TNF-α in patients with wind-cold-dampness arthralgia was （36.11±8.10） pg/mL, which was significantly higher than that of liver and kidney yin deficiency, spleen kidney yang deficiency and stagnation of vital energy and blood stasis （P〈0.05）; There was no significant difference in IL-6, CRP and ESR in different TCM syndrome types （P〉0.05）. Conclusion The Wnt-3α, BMP-2 and TNF-α expression in patients with wind-cold-dampness arthralgia are significantly increased, while no significant differences in each index of patients with liver and kidney yin deficiency, spleen kidney yang deficiency and stagnation of vital energy and blood stasis.