关节液血管活性肠肽水平、白细胞介素-1β、基质金属蛋白酶3与踝创伤性关节炎症状严重程度、足踝功能的相关性分析

Correlation analysis of synovial fluid VIP, IL-1β, matrix metalloproteinase 3 with symptom severity and ankle function in patients with traumatic ankle arthritis

目的探究关节液血管活性肠肽(VIP)、白细胞介素-1β(IL-1β)、基质金属蛋白酶3(MMP3)与踝创伤性关节炎(PTAOA)患者症状严重程度、足踝功能的相关性。方法选取安阳市人民医院2018年1月至2019年5月踝创伤性关节炎病人72例作为研究对象,根据改良K-L分级分为2级(22例)、3级(30例)、4级(20例)。检测对比不同分级病人关节液VIP、IL-1β、MMP3水平、症状(疼痛、肿胀)评分及足踝功能(AOFAS)评分,Pearson相关性分析关节液VIP、IL-1β、MMP3与症状、足踝功能关联性。结果关节液VIP水平随改良K-L分级增加呈降低趋势,IL-1β、MMP3呈升高趋势(P<0.05);4级病人疼痛、肿胀评分高于3级、2级病人(P<0.05);关节液VIP与疼痛、肿胀呈负相关,IL-1β、MMP3与疼痛、肿胀呈正相关(P<0.05);4级病人功能和自主活动及支撑、最大步行距离、踝-后足稳定性、足部对线评分低于3级、2级病人(P<0.05);关节液VIP与功能和自主活动及支撑、最大步行距离呈正相关,IL-1β、MMP3与功能和自主活动及支撑、最大步行距离呈负相关(P<0.05)。结论关节液VIP、IL-1β、MMP3在PTAOA病人中表达明显异常,与病情、症状严重程度、足踝功能显著相关,调控VIP、IL-1β、MMP3表达可能为PTAOA的防治提供一个潜在的思路。

Objective To investigate the correlation of synovial fluid vasoactive intestinal peptide(VIP),interleukin-1β(IL-1β),and matrix metalloproteinase 3(MMP3)with symptom severity and foot and ankle function in patients with ankle traumatic arthritis(PTAOA).Methods Seventy-two patients with traumatic ankle arthritis in Anyang People’s Hospital from January 2018 to May 2019 were selected as the research objects.They were divided into the second grade(22 cases),the third grade(30 cases),and the fourth grade(20 cases)according to the improved K-L classification.Detection and comparison of joint fluid VIP,IL-1β,MMP3 levels,symptom(pain,swelling)score and ankle function(AOFAS)score of patients with different grades were conducted,Pearson correlation was used to analyze the association of VIP,IL-1β,MMP3 with symptoms and foot and ankle function.Results With the increase of the grade of K-L,and IL-1β,VIP level of synovial fluid decreased,while MMP3 increased(P<0.05).The score of pain and swelling in the fourth grade was higher than that in the third and second grade(P<0.05);VIP of joint fluid was negatively correlated with pain and swelling,while IL-1βand MMP3 were positively correlated with pain and swelling(P<0.05);In the fourth level,the patients’function,autonomous activity and support,maximum walking distance,ankle hind foot stability,foot alignment score were lower than the third level and the second level(P<0.05);There was a positive correlation between VIP and function,autonomic activity and support,maximum walking distance,and a negative correlation between IL-1β,MMP3 and function,autonomic activity and support,maximum walking distance(P<0.05).Conclusion The expression of VIP,IL-1βand MMP3 in synovial fluid is significantly abnormal in patients with PTAOA,which is significantly related to the condition,symptom severity and ankle function.Regulating the expression of VIP,IL-1βand MMP3 may provide a potential idea for the prevention and treatment of PTAOA.