创伤性膝关节骨性关节炎患者血清MMP-13、瘦素和IL-6水平及其预后影响因素分析

Serum Levels of MMP-13,Leptin and IL-6 and Factors Affecting Prognoses of Patients with Traumatic Knee Osteoarthritis

目的探讨创伤性膝关节骨性关节炎(KOA)患者血清基质金属蛋白酶-13(MMP-13)、瘦素和白细胞介素-6(IL-6)水平及其预后影响因素。方法选取2018年2月-2019年10月收治的创伤性KOA 65例作为创伤性KOA组,同期健康体检者50例作为健康对照组;另外,根据术前凯尔格伦-劳伦斯(K-L)分级将创伤性KOA 65例分为Ⅰ级组(17例)、Ⅱ级组(19例)、Ⅲ级组(15例)和Ⅳ级组(14例)4组。比较创伤性KOA组和健康对照组及术前不同K-L分级4组血清MMP-13、瘦素和IL-6水平,应用Pearson相关性分析探讨血清MMP-13、瘦素和IL-6水平与美国膝关节协会评分(KSS)、特种外科医院膝关节评分(HSS)的相关性,应用单因素和多因素Logistic回归分析探讨创伤性KOA患者预后影响因素。结果创伤性KOA组血清MMP-13、瘦素和IL-6水平均高于健康对照组,差异有统计学意义(P<0.01)。随着创伤性KOA患者术前K-L分级增高,血清MMP-13、瘦素和IL-6水平逐渐升高,术前不同K-L分级4组间两两比较差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,创伤性KOA患者血清MMP-13、瘦素和IL-6水平与美国KSS、HSS均呈负相关(P<0.05或P<0.01)。多因素Logistic回归分析结果显示,术前K-L分级、术中软骨Outerbridge分级和血清MMP-13、瘦素、IL-6水平是影响创伤性KOA患者预后的独立危险因素(P<0.05或P<0.01)。结论创伤性KOA患者血清MMP-13、瘦素和IL-6水平升高,且其水平与术前K-L分级、膝关节功能密切相关。术前K-L分级、术中软骨Outerbridge分级和血清MMP-13、瘦素、IL-6水平是影响创伤性KOA患者预后的独立危险因素。

Objective To analyze serum levels of matrix metalloproteinase-13(MMP-13),leptin and interleukin-6(IL-6)and the factors affecting prognoses of patients with traumatic knee osteoarthritis(KOA).Methods A total of 65 patients with traumatic KOA admitted between February 2018 and December 2019 were selected as traumatic KOA group,and other 50 healthy people who had undergone normal physical examination were selected as healthy control group.In addition,65 patients with traumatic KOA were divided into grade I subgroup(n=17),grade II subgroup(n=19),grade III subgroup(n=15)and grade IV subgroup(n=14)according to the preoperative Kellgren-Lawrence(KL)classification.Expressions of MMP-13,leptin and IL-6 between traumatic KOA and healthy control groups and before operation in the four subgroups at different KL grades were compared.Pearson correlation analysis was used to investigate correlations between serum levels of MMP-13,leptin and IL-6 with the scores of American Knee Society Score(KSS)and hospital for special surgery knee score(HSS).Univariate and multivariate logistic regression analysis were used to investigate the factors affecting prognoses of patients with traumatic KOA.Results Serum levels of MMP-13,leptin and IL-6 in traumatic KOA group were significantly higher than those in healthy control group(P<0.01).With the increasing KL grade before operation in patients with traumatic KOA,serum levels of MMP-13,leptin and IL-6 were gradually increased,and the differences in the above levels were statistically significant between pairwise comparison among the four subgroups at different KL grades(P<0.05).Pearson correlation analysis showed that serum levels of MMP-13,leptin and IL-6 in patients with traumatic KOA were negatively correlated with KSS and HSS scores(P<0.05 or P<0.01).Results of multivariate logistic regression analyses showed that preoperative KL grade,intraoperative cartilage Outerbridge grade and serum levels of MMP-13,leptin and IL-6 were independent risk factors affecting prognoses of patients with traumatic KOA(P<0.05 or P<0.01).Conclusion Serum levels of MMP-13,leptin and IL-6 in patients with traumatic KOA are increased,and the levels are closely related to the preoperative K-L grade and knee joint function.Preoperative K-L grade,intraoperative cartilage Outerbridge grade and serum levels of MMP-13,leptin and IL-6 are independent risk factors affecting the prognoses of patients with traumatic KOA.