寒湿痹阻型膝骨关节炎疼痛与髌股关节影像学及致炎因子表达的相关性研究

Study on the Correlation between Pain of Knee Osteoarthritis with Cold and Dampness Obstruction and the Expression of Patellofemoral Joint Imaging and Inflammatory Factors

目的:探讨寒湿痹阻型膝骨关节炎疼痛与髌股关节影像学及致炎因子水平的相关性,为临床诊疗提供依据。方法:回顾性分析医院骨科门诊及住院部2018年6月至2021年12月收治的寒湿痹阻型膝骨关节炎患者92例临床资料。采用视觉模拟评分法(VAS)进行疼痛评估,分为轻度、中度、重度。所有患者拍摄髌骨轴位片,分别对髌股关节间隙狭窄和骨赘进行分级;同时,查血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平。分析寒湿痹阻型膝骨关节炎患者疼痛评分与髌股关节影像学表现及致炎因子水平的相关性。结果:膝骨关节炎不同疼痛组内侧髌股关节间隙狭窄,髌骨内侧和外侧骨赘严重程度比较,差异无统计学意义(P>0.05),外侧髌股关节间隙狭窄程度,血清IL-6和TNF-α表达水平比较,有显著性差异(P<0.05),且相关性分析显示疼痛与外侧髌股关节间隙的狭窄程度(r=0.333,P<0.001),血清TNF-α(r=0.507,P<0.001)和IL-6(r=0.480,P<0.001)水平均存在显著的正相关。结论:寒湿痹阻型膝骨关节炎患者的髌骨关节间隙狭窄程度以及血清TNF-α、IL-6水平与疼痛程度呈正相关。

Objective:To investigate the correlation between the pain of knee osteoarthritis with patellofemoral joint imaging and inflammatory factors,so as to provide evidence for clinical diagnosis and treatment.Methods:A retrospective analysis was performed on 92 patients with knee osteoarthritis with cold and dampness obstruction admitted to the department of orthopedics outpatient and inpatient department of our hospital from June 2018 to December 2021.Pain was assessed by visual analogue scale(VAS),which was divided into mild,moderate,and severe.Axial radiographs of patella were taken in all patients,and patellofemoral joint space stenosis and osteophyte were graded respectively.Meanwhile,the levels of serum TNF-αand IL-6 were examined.To analyze the correlation between pain score and imaging manifestations of patellofemoral joint and inflammatory factors in patients with cold and dampness obstructive knee osteoarthritis.Results:There were no significant differences in the severity of medial patellofemoral joint space stenosis and medial and lateral osteophytes of patella in different pain groups(P>0.05).There were significant differences in the degree of stenosis in the lateral patellofemoral joint space and the expression levels of serum IL-6 and TNF-α(P<0.05),and correlation analysis showed that pain was significant positively related to the degree of stenosis of the lateral patellofemoral joint space(r=0.333,P<0.001),serum TNF-α(r=0.507,P<0.001)and IL-6 levels(r=0.480,P<0.001).Conclusion:The degree of patellar joint space stenosis and serum levels of TNF-αand IL-6 are positively correlated with the degree of pain in patients with cold and dampness obstructive knee osteoarthritis.