膝骨性关节炎疾病程度及合并疾病情况对患者血清组织蛋白酶D、α1抗胰蛋白酶活性的影响及其临床意义

Effect of the degree of knee osteoarthritis and the comorbid conditions on the activity of serum cathepsin D and α1 antitrypsin in patients and its clinical significance

目的探讨膝骨性关节炎疾病程度及合并疾病情况对患者血清组织蛋白酶D、α1抗胰蛋白酶活性的影响及其临床意义。方法回顾性选取2016年2月至2022年2月解放军联勤保障部队940医院和中核四〇四医院骨科收治的膝骨性关节炎患者80例作为病例组、健康体检人员20名作为健康组。统计分析病例组不同程度、不同高血压情况、不同糖尿病情况患者的血清CAT-D、AAT活性,并统计分析2组手术前后的血清CAT-D、AAT活性。结果病例组Ⅰ期、Ⅱ期患者的血清CAT-D、AAT活性均高于Ⅲ期、Ⅳ期患者,Ⅰ期患者的血清CAT-D、AAT活性均低于Ⅱ期患者,Ⅲ期患者的血清CAT-D活性高于Ⅳ期患者,血清AAT活性低于Ⅳ期患者,差异均有统计学意义(P<0.05)。病例组高血压和非高血压患者的血清CAT-D、AAT活性之间的差异均无统计学意义(P>0.05)。病例组糖尿病和非糖尿病患者的血清CAT-D、AAT活性之间的差异均无统计学意义(P>0.05)。手术前,病例组患者的血清CAT-D、AAT活性均低于健康组,差异均有统计学意义(P<0.05);手术后,病例组患者的血清CAT-D活性低于手术前,血清AAT活性高于手术前,病例组患者的血清CAT-D活性低于健康组,血清AAT活性高于健康组,差异均有统计学意义(P<0.05)。结论血清组织蛋白酶D、α1抗胰蛋白酶活性水平随膝骨性关节炎患者病变程度而发生变化,而与患者是否合并高血压、糖尿病无关。检测血清组织蛋白酶D、α1抗胰蛋白酶活性水平能够为判定膝骨性关节炎患者软骨退变程度提供有效依据。

Objective To investigate the effect of the degree of knee osteoarthritis and the comorbid conditions on the activities of serum cathepsin D and α1 antitrypsin in patients and its clinical significance.Methods A total of 80 patients with knee osteoarthritis in Department of Orthopedics, 940 Hospital of PLA Joint Logistic Support Force and China National Nuclear No. 4 Hospital from February 2016 to February 2022 were retrospectively selected as the case group and 20 healthy persons were selected as the health group. The serum CAT-D and AAT activities of patients with different degrees, hypertension and diabetes mellitus in the case group were statistically analyzed, and the serum CAT-D and AAT activities before and after surgery in the two groups were statistically analyzed.Results The activities of serum CAT-D and AAT in patients with stage Ⅰ and Ⅱ were higher than those in patients with stage Ⅲ and Ⅳ, the serum CAT-D and AAT activities in stage Ⅰ patients were lower than those in stage Ⅱ patients, the serum CAT-D activity in stage Ⅲ patients was higher than that in stage Ⅳ patients, the serum AAT activity was lower than that of stage Ⅳ patients, the differences were statistically significant(P<0.05). There was no statistically significant difference in serum CAT-D and AAT activity between hypertensive and non-hypertensive patients in the case group(P>0.05). There was no statistically significant difference in serum CAT-D and AAT activity between diabetic patients and non-diabetic patients(P>0.05). Before operation, the serum CAT-D and AAT activities in case group were lower than those in healthy group, the differences were statistically significant(P<0.05);after operation, the serum CAT-D activity of patients in case group was lower than that before operation, serum AAT activity was higher than that before operation, the serum CAT-D activity in case group was lower than that in healthy group, serum AAT activity was higher than that of healthy group, the differences were statistically significant(P<0.05).Conclusion Serum cathepsin D and α1 antitrypsin activity levels changed with the degree of pathological changes in patients with knee osteoarthritis, regardless of whether the patients were complicated with hypertension or diabetes. Detection of serum cathepsin D and α1 antitrypsin activity levels can provide an effective basis for judging the degree of cartilage degeneration in patients with knee osteoarthritis.