创伤性膝骨关节炎患者血清IL-6,TNF-α,瘦素水平表达与影像学K-L分级的相关性

Association between Levels of Serum Inflammatory Cytokines and Imaging Severity in Patients with Post-traumatic Knee Osteoarthritis

目的探讨创伤性膝骨关节炎(post-traumatic knee osteoarthritis,PTOA)患者血清促炎症因子的表达及其与影像学分级严重程度的相关性。方法收集2013年1月~2017年12月在陕西省榆林市第二医院确诊的63例PTOA患者,30例健康体检者的临床资料纳入研究。采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)法检测受试者血清中促炎症因子(IL-6,TNF-α和瘦素)的水平。结果与健康对照组相比,PTOA患者血清中促炎症因子(IL-6,TNF-α和瘦素)水平显著增高(IL-6:15.87±5.59 ng/L vs 7.04±2.42 ng/L;TNF-α:41.40±14.63 ng/L vs 24.53±10.37 ng/L;瘦素:15.52±6.43μg/L vs 5.21±3.19μg/L),差异均有统计学意义(t=7.961,5.164,8.292,均P<0.001)。进一步通过K-L分级对影像学严重程度分为4组,结果显示4组间血清促炎症因子水平差异有统计学意义(F=5.974,7.090,均P<0.001),且血清促炎症因子(IL-6,TNF-α和瘦素)水平随着膝关节损伤严重程度增加而增高。相关性分析显示血清IL-6与TNF-α(r=0.458)、瘦素(r=0.563)呈正相关,TNF-α与瘦素(r=0.692)呈正相关(均P<0.001)。结论血清促炎症因子(IL-6,TNF-α和瘦素)水平在PTOA患者显著增高,且与K-L分级密切相关,可作为一个潜在的生物标记物反映PTOA患者膝关节损伤的严重程度。

Objective To investigate the levels of serum inflammatory cytokines in patients with post-traumatic knee osteoarthritis(PTOA)and the correlation with the severity of imaging.Methods 63 cases of PTOA patients and 30 cases of healthy control,admitted to the Second Hospital of Yulin from January 2013 to December 2017,were enrolled in this study.The levels of serum inflammatory cytokines(IL-6,TNF-αand leptin)was detected by enzyme linked immunosorbent assay(ELISA).Results The levels of serum inflammatory cytokines(IL-6,TNF-αand leptin)were significantly increased in PTOA patients compared with healthy controls(HC)(IL-6:15.87±5.59 ng/L vs 7.04±2.42 ng/L,TNF-α:41.40±14.63 ng/L vs 24.53±10.37 ng/L,leptin:15.52±6.43μg/L vs 5.21±3.19μg/L),the differences were statistically significant(t=7.961,5.164 and 8.292,all P<0.001).The severity of imaging was further divided into 4 groups by Kellgren-Lawrence grade,the results showed that the levels of serum proinflammatory cytokines(IL-6,TNF-αand leptin)were significantly different among the 4 groups(F=5.974,7.090,all P<0.001),and the level of serum proinflammatory cytokines(IL-6,TNF-αand leptin)were increases with the severity of knee injury.Correlation analysis showed that serum IL-6 was positively correlated with TNF-α(r=0.458)and leptin(r=0.563),and TNF-αwas positively correlated with leptin(r=0.692)(all P<0.001).Conclusion The levels of serum proinflammatory cytokines(IL-6,TNF-αand leptin)were increased in patients with PTOA and was associated with K-L grade and suggesting that proinflammatory cytokines may be a potential markers for reflect the severity of knee joint injury in patients with PTOA.