补肾活血方干预绝经后膝骨关节炎血清学炎症指标与MRI半定量评分相关性研究

Study on Correlation Between Serological Inflammation Indexes and MRI Semi-quantitative Scores of Postmenopausal Knee Osteoarthritis under the Intervention of Bushen Huoxue Recipe

目的 探讨补肾活血方干预绝经后膝骨关节炎患者的血清学炎症指标与磁共振成像(magnetic resonance imaging,MRI)半定量评分的相关性。方法 选取绝经后膝骨关节炎患者70例,采用随机数字表法分为治疗组和对照组,最终67例完成研究。2组均给予基础治疗,在此基础上,治疗组(n=33)采用补肾活血方治疗,对照组(n=34)采用塞来昔布胶囊治疗,2组疗程均为4周。比较2组治疗前后血清学基质金属蛋白酶-13(matrix metalloproteinase-13,MMP-13)、Ⅱ型胶原C端肽(C-telopeptide of typeⅡcollagen,CTX-Ⅱ)、白介素-1β(interleukin-1β,IL-1β)等指标的变化,并分析其与膝关节MRI半定量评分的相关性。结果 干预后,治疗组血清学指标MMP-13、CTX-Ⅱ、IL-1β的表达较前下降(P<0.01),但治疗组上述指标高于对照组(P<0.01)。2组软骨下骨髓水肿、关节腔积液等MRI半定量评分均较前降低(P<0.01),但组间比较,差异无统计学意义(P>0.05)。治疗前MMP-13、CTX-Ⅱ、IL-1β与软骨损伤评分呈良好正相关(r=0.569,P<0.01;r=0.579,P<0.01;r=0.416,P<0.01),但治疗组仅有MMP-13治疗前后变化与关节腔积液评分变化呈弱正相关(r=0.391,P<0.05),对照组仅有MMP-13变化与软骨下骨髓水肿评分变化呈弱正相关(r=0.347,P<0.05),其余均无明显相关性(P>0.05)。结论 补肾活血方可抑制炎症反应,改善软骨下骨髓水肿和关节腔积液的MRI半定量评分,且炎症指标的降低程度或不能预测MRI影像的改善情况。

Objective To explore the correlation between serological inflammation indexes and semi-quantitative scores of magnetic resonance imaging(MRI)in postmenopausal patients with knee osteoarthritis under the intervention of Bushen Huoxue recipe.Methods Seventy patients with postmenopausal knee osteoarthritis were selected and divided into treatment group and control group by random number table method,and 67 patients were finally enrolled.Both groups were given basic treatment.On this basis,the treatment group(n=33)was treated with Bushen Huoxue recipe,and the control group(n=34)was treated with celecoxib capsule.The treatment course in the two groups were four weeks.The changes of serum matrix metalloproteinase-13(MMP-13),C-telopeptide of typeⅡcollagen(CTX-Ⅱ)and interleukin-1β(IL-1β)in the two groups were compared before and after treatment,and their correlation with semi-quantitative scores of MRI of the knee were analyzed.Results After intervention,the expression of serological indexes MMP-13,CTX-Ⅱand IL-1βin the treatment group were decreased compared with those before treatment(P<0.01),but the above indexes in the treatment group were higher than those in the control group(P<0.01).The MRI semi-quantitative scores of subchondral bone marrow edema and jovnt carvity effusion in the two groups were decreased compared with those before treatment(P<0.01).But there was no significant difference between the two groups(P>0.05).There were positive correlations between MMP-13,CTX-Ⅱand IL-1βand cartilage injury scores before treatment(r=0.569,P<0.01;r=0.579,P<0.01;r=0.416,P<0.01).But there was a weak positive correlation between the changes of MMP-13 and joint cavity scores in the treatment group(r=0.391,P<0.05),and a weak positive correlation between the changes of MMP-13 and subchondal bome marroux edema scores in the control group(r=0.347,P<0.05).And the rest had no significant correlation(P>0.05).Conclusion Bushen Huoxue recipe could inhibit inflammatory response,improve the MRI semi-quantitative scores of subchondral bone marrow edema and joint cavity effusion.Moreover,the reduction degree of inflammatory indicators may not predict the improvement of MRI.