炎症因子在肩袖损伤大鼠中的表达及其临床意义

Clinical significance and expression of inflammatory factors of rats with rotator cuff injury

目的:探讨肩袖损伤大鼠肩关节液中白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)等炎症因子的表达规律及其与大鼠疼痛等症状之间的相关性,为研究肩袖损伤诊治及康复的病理生理学过程提供理论基础.方法:选择60只spraguedaw(SD)大鼠,分为手术组及假手术组,每组30只,手术组切断约1/2冈上肌肌腱模拟肩袖损伤.于术后第2、4、8周,采用酶联免疫吸附试验(ELISA)方法检测关节液及滑囊TNF-α、IL-1β、IL-6水平,统计组间差异.同时评估大鼠关节疼痛评分,并分析炎症因子与疼痛之间的相关性.结果:在3个观测时间点,手术组的TNF-α、IL-1β、IL-6水平和关节疼痛评分均高于对照组(P<0.05),随着术后时间的延长,炎症因子表达水平和关节疼痛评分逐渐降低,手术组关节疼痛评分与IL-1β、IL-6、TNF-α的含量呈正相关.结论:肩袖损伤可导致关节液中炎症因子的过度表达,并加剧肩关节疼痛,随着术后时间的延长,炎症因子逐渐消退,疼痛逐渐减轻.关节液中IL-1β、IL-6、TNF-α3种炎症因子与关节疼痛呈正相关,炎症因子水平可作为肩袖损伤疼痛诊治疗效评价的客观依据.

Objective:The aim of this study was to determine the association of the synovial fluid level of IL-1β,IL-6,TNF-αand other inflammatory factors with pain and other symptoms on rotator cuff injury in a rat model.The research could provide a theoretical basis for pathophysiological process of diagnosis and treatment.Methods:Sixty spraguedaw(SD)rats were divided into operation group and sham operation group.(n=30 in each group).In the operation group,half of the supraspinatus tendon was incised to simulate injured rotator cuff.At the 2,4,8-week time points postoperatively,the levels of TNF-α,IL-1β,and IL-6 in synovial fluid were measured by Enzyme-Linked Immunosorbent Assays(ELISA),and the differences between the groups were statistically analyzed.Rat joint pain scores were also assessed and the correlation between inflammatory factors and pain was analyzed.Results:At three time points,the level of TNF-α,IL-1β,IL-6 and joint pain scores of the operation group were higher than those of the control group(P<0.05).With the prolongation of postoperative time,the level of inflammatory factors and joint pain score gradually decreased,and the joint pain score of the operation group was positively correlated with the level of IL-1β,IL-6 and TNF-α.Conclusion:The rotator cuff injury can lead to over-expression of inflammatory factors in synovial fluid and aggravate shoulder joint pain.With the prolongation of postoperative time,the inflammatory factors gradually subsided and the pain gradually reduced.These three inflammatory factors(IL-1β,IL-6 and TNF-α)in synovial fluid were positively correlated with joint pain.The level of inflammatory factors can be used as an objective evidence for the evaluation of the therapeutic effect of rotator cuff injury.