AIM:To investigate thrombotic microangiopathy (TMA)in liver transplantion,because TMA is an infrequent but life-threatening complication in the transplantation field. METHODS:A total of 206 patients who underwent livi...AIM:To investigate thrombotic microangiopathy (TMA)in liver transplantion,because TMA is an infrequent but life-threatening complication in the transplantation field. METHODS:A total of 206 patients who underwent living-donor liver transplantation (LDLT) were evaluated,and the TMA-like disorder (TMALD) occurred in seven recipients. RESULTS:These TMALD recipients showed poor outcomes in comparison with other 199 recipients. Although two TMALD recipients successfully recovered,the other five recipients finally died despite intensive treatments including repeated plasma exchange (PE) and re-transplantation. Histopathological analysis of liver biopsies after LDLT revealed obvious differences according to the outcomes. Qualitative analysis of antibodies against a disintegrin-like domain and metalloproteinase with thrombospondin type 1 motifs (ADAMTS-13) were negative in all patients. The fragmentation of red cells,the microhemorrhagic macules and the platelet counts were early markers for the suspicion of TMALD after LDLT. Although the absolute values of von Willebrand factor (vWF) and ADAMTS-13 did not necessarily reflect TMALD,the vWF/ADAMTS-13 ratio had a clear diagnostic value in all cases. The establishment of adequate treatments for TMALD,such as PE for ADAMTS-13 replenishment or treatments against inhibitory antibodies,must be decided according to each case. CONCLUSION:The optimal induction of adequate therapies based on early recognition of TMALD by the reliable markers may confer a large advantage for TMALD after LDLT.展开更多
目的:通过系统评价与Meta分析探索Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶7(ADAMTS7)基因rs3825807位点单核苷酸的多态性与冠心病发病风险的关联。方法:计算机检索PubMed, Web of Science, Cochrane Library,中国知网,万方,维普...目的:通过系统评价与Meta分析探索Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶7(ADAMTS7)基因rs3825807位点单核苷酸的多态性与冠心病发病风险的关联。方法:计算机检索PubMed, Web of Science, Cochrane Library,中国知网,万方,维普和中国生物医学数据库,以获取ADAMTS7基因rs3825807多态性与冠心病易感性的原始研究。检索时限均为建库至2019年12月6日。由两位研究者独立筛选文献、提取数据并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果:共纳入6个病例-对照研究,观察组包括4 989例病例,对照组包含5 471例。Meta分析结果显示,患者ADAMTS7基因rs3825807多态性与冠心病的发病风险增加有相关性(AA vs, GG:OR=21.07,95%CI:1.61~275.95,P=0.02;AG vs. GG:OR=6.80,95%CI:0.77~60.11,P=0.08;AA+AG vs. GG:OR=13.19,95%CI:1.09~158.97,P=0.04;AA vs. AG+GG:OR=2.39,95%CI:1.44~3.96,P=0.0007;A vs. G:OR=23.44,95%CI:8.19~67.10,P<0.00001)。结论:患者ADAMTS7基因rs3825807多态性是冠心病的发病风险因素之一。受纳入研究数量和质量限制,本研究需更多的高质量临床研究予以验证。展开更多
目的:检测大鼠蛛网膜下腔出血(subarachnoid hemorrhage,SAH)后早期海马组织中含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶-1(a disintegrin-like and metalloproteinase with thrombospondin type l motifs,ADAMTS-1)在基底动脉...目的:检测大鼠蛛网膜下腔出血(subarachnoid hemorrhage,SAH)后早期海马组织中含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶-1(a disintegrin-like and metalloproteinase with thrombospondin type l motifs,ADAMTS-1)在基底动脉中的表达,分析其与大鼠SAH后急性脑血管痉挛(cerebral vasospasm,CVS)的相关性,探讨其在SAH后早期脑损伤(earlybrain injury,EBI)中的作用。方法:健康雄性成年SD大鼠108只,体质量250～300g,随机分为SAH组(n=90)和假手术组(sham组,n=18)。SAH组取大鼠自体动脉血,用视交叉池注血法建立大鼠SAH模型(sham组注入等量0.9%氯化钠液)。将SAH组随机分为6h、12h、24h、48h、72h5个亚组,每个亚组18只,分别在相应时间点处死。用蛋白质印迹(Western-blot)方法及实时荧光定量逆转录-聚合酶链反应(RT-PCR)法检测SAH各亚组及sham组基底动脉ADAMTS-1的表达,同时用HE染色法对基底动脉进行形态学观察。探讨ADAMTS-1与实验性大鼠SAH后急性CVS的相关性。结果:与sham组相比,SAH 6h亚组基底动脉ADAMTS-1表达无显著差异;12h亚组基底动脉ADAMTS-1蛋白表达显著增高,24h亚组最高,48h亚组、72h亚组逐渐下降,但仍维持在较高水平。与sham组相比,SAH 6h亚组大鼠基底动脉变化不明显;12h亚组大鼠基底动脉管腔缩小,管壁增厚;24h亚组基底动脉痉挛最为明显;48h亚组基底动脉痉挛较24h亚组减轻;与24h亚组、48h亚组相比,72h亚组基底动脉管腔直径更大、管壁厚度更薄。ADAMTS-1蛋白表达与SAH后急性CVS呈正相关(r=0.916,P=0.003)。结论:大鼠SAH后早期基底动脉ADAMTS-1表达与急性CVS正相关,提示ADAMTS-1可能参与大鼠SAH后EBI的病理过程。展开更多
A disintegrin-like and metalloproteinase with thrombospondin type-1 motifs 13(ADAMTS13) specifically cleaves unusually-large von Willebrand factor(VWF) multimers under high shear stress,and down-regulates VWF function...A disintegrin-like and metalloproteinase with thrombospondin type-1 motifs 13(ADAMTS13) specifically cleaves unusually-large von Willebrand factor(VWF) multimers under high shear stress,and down-regulates VWF function to form platelet thrombi.Deficiency of plasma ADAMTS13 activity induces a life-threatening systemic disease,termed thrombotic microangiopathy(TMA) including thrombotic thrombocytopenic purpura(TTP).Children with advanced biliary cirrhosis due to congenital biliary atresia sometimes showed pathological features of TMA,with a concomitant decrease of plasma ADAMTS13 activity.Disappearance of their clinical findings of TTP after successful liver transplantation suggested that the liver is a major organ producing plasma ADAMTS13.In situ hybridization analysis showed that ADAMTS13 was produced by hepatic stellate cells.Subsequently,it was found that ADADTS13 was not merely responsible to development of TMA and TTP,but also related to some kinds of liver dysfunction after liver transplantation.Ischemia-reperfusion injury and acute rejection in liver transplant recipients were often associated with marked decrease of ADAMTS13 and concomitant formation of unusually large VWF multimers without findings of TMA/TTP.The similar phenomenon was observed also in patients who underwent hepatectomy for liver tumors.Imbalance between ADAMTS13 and VWF in the hepatic sinusoid might cause liver damage due to microcirculatory disturbance.It can be called as "local TTP like mechanism" which plays a crucial role in liver dysfunction after liver transplantation and surgery.展开更多
安徽医科大学校科学研究基金（2011xkj083）；2010年卫生系统合肥市科研计划项目第11号项目[摘要]目的探讨脓毒症患者血清假血友病因子（VWF）、血管性血友病因子裂解酶（ADAMTSl3）水平变化的临床意义。方法收集66例脓毒症患者的血清...安徽医科大学校科学研究基金（2011xkj083）；2010年卫生系统合肥市科研计划项目第11号项目[摘要]目的探讨脓毒症患者血清假血友病因子（VWF）、血管性血友病因子裂解酶（ADAMTSl3）水平变化的临床意义。方法收集66例脓毒症患者的血清及临床资料，并从正常人群中随机抽取20例志愿者的血清，采用ELISA法分别定量检测血清VWF和ADAMTS13水平。把脓毒症患者分为脓毒症（sepsis，S）组、严重脓毒症（severesepsis，SS）组及多器官功能障碍综合征（multiple organ dysfunction syndrome, MODS）组，与正常对照（c）组比较，观察血清VWF、ADAMTS13水平变化与脓毒症严重程度之间的关系。结果S组、SS组和MODS组血清VWF、ADAMTS13水平与C组比较差异有统计学意义（P〈0．05）。S组和SS组血清VWF水平显著高于C组，MODS组VwF水平较S组和SS组显著增高，ADAMTS13水平在脓毒症各组均显著低于C组。结论VWF、ADAMTSl3从脓毒症发病早期即开始参与，患者血清VwF水平的变化在预测脓毒症预后较ADAMTS13更敏感。展开更多
目的 探讨膜性及非膜性肾病综合征（nephrotic syndrome,NS）患者治疗前后血浆中血管性血友病因子裂解酶（a disintegrin-like and metalloprotease with thrombospondin type I repeats 13,ADAMTS13）及血管性血友病因子（von Willebra...目的 探讨膜性及非膜性肾病综合征（nephrotic syndrome,NS）患者治疗前后血浆中血管性血友病因子裂解酶（a disintegrin-like and metalloprotease with thrombospondin type I repeats 13,ADAMTS13）及血管性血友病因子（von Willebrand factor,vWF）的变化其临床意义.方法 将60例NS患者分为膜性肾病组（n=21）、非膜性肾病组（n=39）,43例健康体检者作为正常对照组,检测各组血、尿生化指标,ELISA法检测各组血浆AD-AMTS13、vWF水平并计算vWF/ADAMTS13比值.结果 与正常对照组相比,治疗前膜性肾病组和非膜性肾病组患者血浆ADAMTS13水平均降低（P＜0.05）,而vWF、vWF/ADAMTS13水平均升高（P＜0.05）.相关分析显示,NS患者血浆ADAMTS13与血清白蛋白（ALB）呈正相关（r=0.668,P＜0.05）,与尿蛋白定量（UTP）、D-dimer和三酰甘油（TG）呈负相关（r=-0.403,r=-0.313,r=-0.281,P＜0.05）.血浆vWF与ALB呈负相关（r=-0.376,P＜0.05）,与总胆固醇（TC）、UTP呈正相关（r=0.328,r=0.269,P＜0.05）.血浆ADAMTS13与vWF之间呈负相关（r=-0.387,P＜0.05）.非膜性肾病组ADAMTS13治疗后较治疗前升高,差异具有统计学意义（P＜0.05）,膜性肾病组ADAMTS13治疗后较治疗前升高,但差异无统计学意义（P ＞0.05）;NS两组血浆vWF及vWF/ADAMTS13比值治疗前后比较差异均无统计学意义（P＞0.05）.结论 vWF、ADAMTS13及vWF/AD-AMTS13与NS高凝状态有关,ADAMTS13可能成为判断肾病综合征病情与预后的新指标.展开更多
背景:目前对骨关节患者滑膜、关节软骨中相关降解酶的研究较多,对关节液中相关因子的检测亦有报道,但有关不同病变分期相关因子表达情况的报道较少,且其与病变程度相关性研究报道亦相对较少。目的:检测不同分期骨关节炎患者关节液中细...背景:目前对骨关节患者滑膜、关节软骨中相关降解酶的研究较多,对关节液中相关因子的检测亦有报道,但有关不同病变分期相关因子表达情况的报道较少,且其与病变程度相关性研究报道亦相对较少。目的:检测不同分期骨关节炎患者关节液中细胞外调节蛋白激酶、基质金属蛋白酶13和人类含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶4/5(a disintegrin and metalloproteinase with thrombospondin-like motifs,ADAMTS4/5)的表达。方法:选择2016年10月至2017年12月在石河子大学医学院第一附属医院骨科行关节镜手术的骨关节炎患者94例,根据临床症状与K-L X射线分级分为早期组(n=27)、中期组(n=32)、晚期组(n=35);选择行截肢的健康患者、单纯膝外伤行关节镜检查者及自愿参与试验的门诊体检者10例,作为对照组。采集4组受试者关节液,采用荧光定量PCR法和ELISA法检测细胞外调节蛋白激酶、基质金属蛋白酶13和ADAMTS4/5的表达情况。试验经石河子大学医学院第一附属医院医学伦理委员会批准,批准号:2017-052-01。结果与结论:①荧光定量PCR检测:早、中、晚期组的各基因表达均高于对照组(P<0.001),早、中、晚期组的细胞外调节蛋白激酶、基质金属蛋白酶13基因表达呈逐渐上升趋势(P<0.01),早期组ADAMTS4/5基因表达高于中、晚期组(P<0.01);②ELISA检测:早、中、晚期组的关节液中各因子表达均高于对照组(P<0.001),早、中、晚期组的细胞外调节蛋白激酶、基质金属蛋白酶13表达呈逐渐上升趋势(P<0.01),早期组ADAMTS4/5表达高于中、晚期组(P<0.01);③相关性分析:细胞外调节蛋白激酶与基质金属蛋白酶13表达水平呈正相关关系(P<0.01),ADAMTS4与ADAMTS5表达呈正相关关系(P<0.01),ADAMTS4、ADAMTS5与细胞外调节蛋白激酶、基质金属蛋白酶13表达水平呈负相关关系(P<0.05);④结果表明:细胞外调节蛋白激酶、基质金属蛋白酶13及ADAMTS4/5的表达与膝骨性关节炎临床症状较为密切,研究这些因子在骨性关节炎不同分期中的分子机制,有望为临床诊断及预后判定提供一定的依据。展开更多
基金Supported by the Grant from Uehara Memorial Foundation, No. 200940051, Tokyo, 171-0033, Japan
文摘AIM:To investigate thrombotic microangiopathy (TMA)in liver transplantion,because TMA is an infrequent but life-threatening complication in the transplantation field. METHODS:A total of 206 patients who underwent living-donor liver transplantation (LDLT) were evaluated,and the TMA-like disorder (TMALD) occurred in seven recipients. RESULTS:These TMALD recipients showed poor outcomes in comparison with other 199 recipients. Although two TMALD recipients successfully recovered,the other five recipients finally died despite intensive treatments including repeated plasma exchange (PE) and re-transplantation. Histopathological analysis of liver biopsies after LDLT revealed obvious differences according to the outcomes. Qualitative analysis of antibodies against a disintegrin-like domain and metalloproteinase with thrombospondin type 1 motifs (ADAMTS-13) were negative in all patients. The fragmentation of red cells,the microhemorrhagic macules and the platelet counts were early markers for the suspicion of TMALD after LDLT. Although the absolute values of von Willebrand factor (vWF) and ADAMTS-13 did not necessarily reflect TMALD,the vWF/ADAMTS-13 ratio had a clear diagnostic value in all cases. The establishment of adequate treatments for TMALD,such as PE for ADAMTS-13 replenishment or treatments against inhibitory antibodies,must be decided according to each case. CONCLUSION:The optimal induction of adequate therapies based on early recognition of TMALD by the reliable markers may confer a large advantage for TMALD after LDLT.
文摘目的:通过系统评价与Meta分析探索Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶7(ADAMTS7)基因rs3825807位点单核苷酸的多态性与冠心病发病风险的关联。方法:计算机检索PubMed, Web of Science, Cochrane Library,中国知网,万方,维普和中国生物医学数据库,以获取ADAMTS7基因rs3825807多态性与冠心病易感性的原始研究。检索时限均为建库至2019年12月6日。由两位研究者独立筛选文献、提取数据并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果:共纳入6个病例-对照研究,观察组包括4 989例病例,对照组包含5 471例。Meta分析结果显示,患者ADAMTS7基因rs3825807多态性与冠心病的发病风险增加有相关性(AA vs, GG:OR=21.07,95%CI:1.61~275.95,P=0.02;AG vs. GG:OR=6.80,95%CI:0.77~60.11,P=0.08;AA+AG vs. GG:OR=13.19,95%CI:1.09~158.97,P=0.04;AA vs. AG+GG:OR=2.39,95%CI:1.44~3.96,P=0.0007;A vs. G:OR=23.44,95%CI:8.19~67.10,P<0.00001)。结论:患者ADAMTS7基因rs3825807多态性是冠心病的发病风险因素之一。受纳入研究数量和质量限制,本研究需更多的高质量临床研究予以验证。
文摘目的:检测大鼠蛛网膜下腔出血(subarachnoid hemorrhage,SAH)后早期海马组织中含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶-1(a disintegrin-like and metalloproteinase with thrombospondin type l motifs,ADAMTS-1)在基底动脉中的表达,分析其与大鼠SAH后急性脑血管痉挛(cerebral vasospasm,CVS)的相关性,探讨其在SAH后早期脑损伤(earlybrain injury,EBI)中的作用。方法:健康雄性成年SD大鼠108只,体质量250～300g,随机分为SAH组(n=90)和假手术组(sham组,n=18)。SAH组取大鼠自体动脉血,用视交叉池注血法建立大鼠SAH模型(sham组注入等量0.9%氯化钠液)。将SAH组随机分为6h、12h、24h、48h、72h5个亚组,每个亚组18只,分别在相应时间点处死。用蛋白质印迹(Western-blot)方法及实时荧光定量逆转录-聚合酶链反应(RT-PCR)法检测SAH各亚组及sham组基底动脉ADAMTS-1的表达,同时用HE染色法对基底动脉进行形态学观察。探讨ADAMTS-1与实验性大鼠SAH后急性CVS的相关性。结果:与sham组相比,SAH 6h亚组基底动脉ADAMTS-1表达无显著差异;12h亚组基底动脉ADAMTS-1蛋白表达显著增高,24h亚组最高,48h亚组、72h亚组逐渐下降,但仍维持在较高水平。与sham组相比,SAH 6h亚组大鼠基底动脉变化不明显;12h亚组大鼠基底动脉管腔缩小,管壁增厚;24h亚组基底动脉痉挛最为明显;48h亚组基底动脉痉挛较24h亚组减轻;与24h亚组、48h亚组相比,72h亚组基底动脉管腔直径更大、管壁厚度更薄。ADAMTS-1蛋白表达与SAH后急性CVS呈正相关(r=0.916,P=0.003)。结论:大鼠SAH后早期基底动脉ADAMTS-1表达与急性CVS正相关,提示ADAMTS-1可能参与大鼠SAH后EBI的病理过程。
文摘A disintegrin-like and metalloproteinase with thrombospondin type-1 motifs 13(ADAMTS13) specifically cleaves unusually-large von Willebrand factor(VWF) multimers under high shear stress,and down-regulates VWF function to form platelet thrombi.Deficiency of plasma ADAMTS13 activity induces a life-threatening systemic disease,termed thrombotic microangiopathy(TMA) including thrombotic thrombocytopenic purpura(TTP).Children with advanced biliary cirrhosis due to congenital biliary atresia sometimes showed pathological features of TMA,with a concomitant decrease of plasma ADAMTS13 activity.Disappearance of their clinical findings of TTP after successful liver transplantation suggested that the liver is a major organ producing plasma ADAMTS13.In situ hybridization analysis showed that ADAMTS13 was produced by hepatic stellate cells.Subsequently,it was found that ADADTS13 was not merely responsible to development of TMA and TTP,but also related to some kinds of liver dysfunction after liver transplantation.Ischemia-reperfusion injury and acute rejection in liver transplant recipients were often associated with marked decrease of ADAMTS13 and concomitant formation of unusually large VWF multimers without findings of TMA/TTP.The similar phenomenon was observed also in patients who underwent hepatectomy for liver tumors.Imbalance between ADAMTS13 and VWF in the hepatic sinusoid might cause liver damage due to microcirculatory disturbance.It can be called as "local TTP like mechanism" which plays a crucial role in liver dysfunction after liver transplantation and surgery.
文摘安徽医科大学校科学研究基金（2011xkj083）；2010年卫生系统合肥市科研计划项目第11号项目[摘要]目的探讨脓毒症患者血清假血友病因子（VWF）、血管性血友病因子裂解酶（ADAMTSl3）水平变化的临床意义。方法收集66例脓毒症患者的血清及临床资料，并从正常人群中随机抽取20例志愿者的血清，采用ELISA法分别定量检测血清VWF和ADAMTS13水平。把脓毒症患者分为脓毒症（sepsis，S）组、严重脓毒症（severesepsis，SS）组及多器官功能障碍综合征（multiple organ dysfunction syndrome, MODS）组，与正常对照（c）组比较，观察血清VWF、ADAMTS13水平变化与脓毒症严重程度之间的关系。结果S组、SS组和MODS组血清VWF、ADAMTS13水平与C组比较差异有统计学意义（P〈0．05）。S组和SS组血清VWF水平显著高于C组，MODS组VwF水平较S组和SS组显著增高，ADAMTS13水平在脓毒症各组均显著低于C组。结论VWF、ADAMTSl3从脓毒症发病早期即开始参与，患者血清VwF水平的变化在预测脓毒症预后较ADAMTS13更敏感。
文摘目的 探讨膜性及非膜性肾病综合征（nephrotic syndrome,NS）患者治疗前后血浆中血管性血友病因子裂解酶（a disintegrin-like and metalloprotease with thrombospondin type I repeats 13,ADAMTS13）及血管性血友病因子（von Willebrand factor,vWF）的变化其临床意义.方法 将60例NS患者分为膜性肾病组（n=21）、非膜性肾病组（n=39）,43例健康体检者作为正常对照组,检测各组血、尿生化指标,ELISA法检测各组血浆AD-AMTS13、vWF水平并计算vWF/ADAMTS13比值.结果 与正常对照组相比,治疗前膜性肾病组和非膜性肾病组患者血浆ADAMTS13水平均降低（P＜0.05）,而vWF、vWF/ADAMTS13水平均升高（P＜0.05）.相关分析显示,NS患者血浆ADAMTS13与血清白蛋白（ALB）呈正相关（r=0.668,P＜0.05）,与尿蛋白定量（UTP）、D-dimer和三酰甘油（TG）呈负相关（r=-0.403,r=-0.313,r=-0.281,P＜0.05）.血浆vWF与ALB呈负相关（r=-0.376,P＜0.05）,与总胆固醇（TC）、UTP呈正相关（r=0.328,r=0.269,P＜0.05）.血浆ADAMTS13与vWF之间呈负相关（r=-0.387,P＜0.05）.非膜性肾病组ADAMTS13治疗后较治疗前升高,差异具有统计学意义（P＜0.05）,膜性肾病组ADAMTS13治疗后较治疗前升高,但差异无统计学意义（P ＞0.05）;NS两组血浆vWF及vWF/ADAMTS13比值治疗前后比较差异均无统计学意义（P＞0.05）.结论 vWF、ADAMTS13及vWF/AD-AMTS13与NS高凝状态有关,ADAMTS13可能成为判断肾病综合征病情与预后的新指标.
文摘背景:目前对骨关节患者滑膜、关节软骨中相关降解酶的研究较多,对关节液中相关因子的检测亦有报道,但有关不同病变分期相关因子表达情况的报道较少,且其与病变程度相关性研究报道亦相对较少。目的:检测不同分期骨关节炎患者关节液中细胞外调节蛋白激酶、基质金属蛋白酶13和人类含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶4/5(a disintegrin and metalloproteinase with thrombospondin-like motifs,ADAMTS4/5)的表达。方法:选择2016年10月至2017年12月在石河子大学医学院第一附属医院骨科行关节镜手术的骨关节炎患者94例,根据临床症状与K-L X射线分级分为早期组(n=27)、中期组(n=32)、晚期组(n=35);选择行截肢的健康患者、单纯膝外伤行关节镜检查者及自愿参与试验的门诊体检者10例,作为对照组。采集4组受试者关节液,采用荧光定量PCR法和ELISA法检测细胞外调节蛋白激酶、基质金属蛋白酶13和ADAMTS4/5的表达情况。试验经石河子大学医学院第一附属医院医学伦理委员会批准,批准号:2017-052-01。结果与结论:①荧光定量PCR检测:早、中、晚期组的各基因表达均高于对照组(P<0.001),早、中、晚期组的细胞外调节蛋白激酶、基质金属蛋白酶13基因表达呈逐渐上升趋势(P<0.01),早期组ADAMTS4/5基因表达高于中、晚期组(P<0.01);②ELISA检测:早、中、晚期组的关节液中各因子表达均高于对照组(P<0.001),早、中、晚期组的细胞外调节蛋白激酶、基质金属蛋白酶13表达呈逐渐上升趋势(P<0.01),早期组ADAMTS4/5表达高于中、晚期组(P<0.01);③相关性分析:细胞外调节蛋白激酶与基质金属蛋白酶13表达水平呈正相关关系(P<0.01),ADAMTS4与ADAMTS5表达呈正相关关系(P<0.01),ADAMTS4、ADAMTS5与细胞外调节蛋白激酶、基质金属蛋白酶13表达水平呈负相关关系(P<0.05);④结果表明:细胞外调节蛋白激酶、基质金属蛋白酶13及ADAMTS4/5的表达与膝骨性关节炎临床症状较为密切,研究这些因子在骨性关节炎不同分期中的分子机制,有望为临床诊断及预后判定提供一定的依据。
