两种术式治疗膝骨性关节炎对IL-17和TGF-β的影响

Effects of two surgical methods on IL-17 and TGF-β in knee osteoarthritis

[目的]探讨两种术式治疗膝骨关节炎的疗效及对白细胞介素17(Interleukin 17,IL-17)、转化生长因子β1(Transforming growth factorβ1,TGF-β1)的影响。[方法]2018年12月—2019年12月在本院接受治疗的膝骨关节炎患者共127例。其中63例采用人工关节置换术治疗(关节置换组),64例行腓骨近端截骨术治疗(截骨组)。比较两组围手术期、实验室检查结果。[结果]两组患者均顺利完成手术,术中无严重并发症。截骨组手术时间、术中出血量、住院时间及住院总费用均低于关节置换组(P<0.05)。与术前相比,术后1个月两组VAS、WOMAC评分水平均显著降低(P<0.05),HSS评分均显著升高(P<0.05)。术后1个月截骨组的上述评分均优于关节置换组(P<0.05)。实验室检查,术后两组血清IL-17均较术前显著降低(P<0.05),而TGF-β1水平较术前显著增加(P<0.05),术后截骨组IL-17和TGF-β1水平均显著低于关节置换组(P<0.05)。[结论]对膝骨关节炎患者中行腓骨近端截骨术效果显著,可有效改善患者IL-17、TGF-β1水平。

[Objective]To study effects of two surgical methods on interleukin 17(IL-17)and transforming growth factor pi(TGF-β1)in knee osteoarthritis.[Methods]A total of 127 patients received surgical treatment for knee osteoarthritis in our hospital from December 2018 to December 2019.Of them,63 patients were treated with total knee arthroplasty(TKA),while the remaining 64 patients underwent proximal fibular osteotomy(PFO).The perioperative data,VAS,WOMAC and HSS scores,as well as serum level of IL-17 and TGF-β1 were compared between the two groups.[Results]All the patients in both groups had operation performed smoothly without serious intraoperative complications.The PFO group proved significantly superior to the TKA group in terms of operation time,intraoperative blood loss,hospital stay and hospital expenses(P<0.05).Compared with those preoperatively,the VAS and WOMAC score significantly decreased(P<0.05),whereas the HSS score significantly increased at 1 month postoperatively(P<0.05).The PFO group proved significantly superior to the TKA group in abovesaid scores at 1 month postoperatively(P<0.05).Regarding to laboratory test,the IL-17 significantly decreased,while the TGF-β1 significantly increased postoperatively in both groups compared with those before operation(P<0.05).The PFO group had significantly lower IL-17 and TGF-β1 than the TKA group postoperatively(P<0.05).[Conclusion]The proximal fibular osteotomy has sound outcomes for knee osteoarthritis,and can effectively improve 11-17 and TGF-β1 levels.