膝骨关节炎疼痛与红外热成像、炎症因子的相关性研究

Correlation between pain of knee osteoarthritis and infrared thermal imaging,inflammatory factors

目的:通过研究疼痛评分与膝关节区域热值评分、骨关节炎指数、炎症因子的相关性,探讨影响膝骨关节炎(knee osteoarthritis,KOA)严重程度的相关因子,寻找一种客观评价疼痛的指标。方法:选取诊断为KOA的患者97例,采用视觉模拟量表(visual analogue scale,VAS)和西安大略和麦克马斯特大学(western ontario and mcMaster,WOMAC)骨关节炎指数评估关节疼痛和关节活动度;以红外热成像测量膝关节区域热值,以ELISA法测量胰岛素样生长因子(insulin-like growth factor1,IGF-1)、细胞因子中白介素1(interleukin-1,IL-1)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、软骨寡聚蛋白(cartilage oligomeric matrix protein,COMP)、透明质酸(haluronic acid,HA)值,分析VAS与膝关节区域热值评分、WOMAC骨关节炎指数评分、IGF-1、IL-1、TNF-α、COMP、HA相关性,建立线性回归方程。结果:疼痛与膝关节区域温度、WOMAC骨关节活动指数、IGF-1、IL-1呈正相关(P<0.05),与HA呈负相关(P<0.05);只有膝关节区域平均热值系数为0.769时呈显著相关性(P<0.05)。结论:KOA的疼痛与膝关节区域热值、WOMAC、IGF-1、IL-1呈正相关,与HA呈负相关。红外热成像对KOA的诊断和疗效评估具有很好的应用价值和前景。

Objective:To study the correlation between pain score and regional calorific value score of knee joint,osteoarthritis index and inflammatory factors.To explore the related factors affecting the severity of knee osteoarthritis,and to find an objective evaluation index of pain.Methods:Ninety-seven patients with knee osteoarthritis were selected and evaluated by visual analogue scale(VAS)and WOMAC index(Western Ontario and McMaster)to assess joint pain and joint mobility.To measure the thermal value of knee joint with infrared thermal imaging,and to measure IGF-1,IL-1,TNF-α,COMP,HA by ELISA,that the relationship between VAS and knee joint regional caloric value score,WOMAC score,IGF-1,IL-1,TNF-α,COMP and HA were analyzed,linear regression equation was established.Results:The pain was positively correlated with the knee area temperature,WOMAC joint activity index,IGF-1,IL-1(P<0.05),and negatively correlated with HA(P<0.05).There was significant correlation between knee joint area with average calorific value of 0.769.Conclusion:The pain of knee osteoarthritis was positively correlated with the knee joint calorific value,WOMAC,IGF-1,IL-1 and negatively correlated with HA.The pain of knee joint by infrared thermal imaging is an objective,visual and accurate evaluation.