踝关节骨折后创伤性骨性关节炎患者外周血IL-1β和MMP-13水平及其与关节功能的相关性研究

Study on the Levels of IL-1β and MMP-13 in Peripheral Blood of Patients with Traumatic Osteoarthritis after Ankle Fracture and Their Relationship with Joint Function

目的 探讨踝关节骨折后创伤性骨性关节炎患者外周血白介素-1β(interleukin-1β,IL-1β)和基质金属蛋白酶-13(matrix metalloproteinase-13,MMP-13)水平变化与关节功能的相关性。方法 选取2018年9月~2020年6月解放军第九六九医院骨科收治的93例踝关节骨折后创伤性骨性关节炎患者作为研究组,另选取同期健康体检者79例作为对照组。两组均采用酶联免疫吸附实验检测外周血IL-1β,MMP-13水平及行踝关节功能测评[踝-后足功能评分(AOFAS)与Kofoed踝关节评分]并对比,另比较研究组不同严重程度患者外周血IL-1β,MMP-13水平及踝关节功能评分,且采用Pearson相关性分析法分析研究组患者外周血IL-1β,MMP-13水平与AOFAS评分、Kofoed踝关节评分的相关性。结果 研究组外周血IL-1β(50.36±7.82pg/ml),MMP-13水平(2.09±0.35ng/L)与对照组(9.84±1.13pg/ml,1.16±0.22 ng/L)比较均升高,差异有统计学意义(t=45.632,20.431,均P<0.05);研究组AOFAS评分(54.69±9.23分)、Kofoed踝关节评分(52.74±8.61分),与对照组比较(90.25±6.27分,89.06±7.34分)均降低,差异均有统计学意义(t=29.019,29.480,均P<0.05);中度、重度患者外周血IL-1β,MMP-13水平均高于轻度患者(t=16.228,5.474;21.840,11.862,均P<0.05),重度患者均高于中度患者(t=12.300,8.146,均P<0.05),差异有统计学意义;中度、重度患者AOFAS评分、Kofoed踝关节评分均低于轻度患者(t=2.875,3.233;7.444,7.690,均P<0.05),重度患者均低于中度患者(t=6.242,5.840,均P<0.05),差异均有统计学意义。经Pearson相关性分析,研究组患者外周血IL-1β,MMP-13水平均与AOFAS评分、Kofoed踝关节评分呈显著负相关(r=-0.852,-0.846;-0.873,-0.868,均P<0.05)。结论 踝关节骨折后创伤性骨性关节炎患者外周血IL-1β,MMP-13水平升高,且均与踝关节功能呈负相关性,并与疾病严重程度存在一定的关系。

Objective To investigate the correlation between the changes of interleukin-1β(IL-1β)and matrix metalloproteinase-13(MMP-13)levels in peripheral blood and joint function in patients with traumatic osteoarthritis after ankle fracture.Methods 93 patients with traumatic osteoarthritis after ankle fracture admitted in Department of Orthopedics of the 969th Hospital of Chinese PLA from September 2018 to June 2020 were selected as the study group,and the 79 healthy persons at the same period were selected as the control group.The levels of IL-1β and MMP-13 in peripheral blood were detected by enzyme linked immunosorbent assay in both groups and the ankle function [American Orthopedic Foot and Ankle Society(AOFAS)and Kofoed ankle score] were assessed and compared.The levels of IL-1β and MMP-13 in peripheral blood and ankle joint function score were also compared of the patients with different severity in the study group,and the correlation between the levels of IL-1β,MMP-13 and AOFAS score and Kofeed ankle score in the study group were analyzed by Pearson correlation analysis method.Results The levels of IL-1β and MMP-13 in peripheral blood of the study group respectively was(50.36±7.82)pg/ml and(2.09±0.35)ng/L,which were higher than those of the control group(9.84±1.13 pg/ml,1.16±0.22ng/L),and the differences were statistically significant(t=45.632,20.431,all P<0.05).The AOFAS score and Kofoed ankle score of the study group respectively was(54.69±9.23)and(52.74±8.61)score,which were lower than those of the control group(90.25±6.27,89.06±7.34),and the differences were statistically significant(t=29.019,29.480,all P<0.05).The levels of IL-1β and MMP-13 in peripheral blood of the moderate and severe patients were higher than those of the mild patients(t=16.229,5.474;21.840,11.862,all P<0.05),of which the severe patients were higher than those of the moderate patients(t=12.300,8.146,all P<0.05),the differences were statistically significant,respectively.The AOFAS score and Kofoed ankle score in moderate and severe patients were lower than those in mild patients(t=2.875,3.233;7.444,7.690,all P<0.05),which in severe patients were lower than those in moderate patients(t=6.242,5.840,all P<0.05),the differences were statistically significant,respectively.Pearson correlation analysis showed that the levels of IL-1β and MMP-13 in peripheral blood of the patients in study group were negatively correlated with AOFAS score and Kofeed ankle score(r=-0.852,-0.846;-0.873,-0.868,all P<0.05).Conclusion The levels of IL-1β and MMP-13 in peripheral blood of patients with traumatic osteoarthritis after ankle fracture were increased,which were negatively correlated with ankle function,and all of them were related to the severity of the disease.