关节滑液炎性细胞因子白细胞介素-8、白细胞介素-17、血管内皮生长因子检测在膝骨性关节炎临床诊断中的应用价值分析
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摘要
目的研究关节滑液炎性细胞因子白细胞介素-8(IL-8)、白细胞介素-17(IL-17)、血管内皮生长因子(VEGF)检测在膝骨性关节炎诊断中的应用。方法选择2016年6月-2018年3月本院接诊76例膝骨性关节炎患者作为研究组,另选择30例单纯膝关节半月板损伤患者作为对照组。对比2组关节滑液中IL-8、IL-17、VEGF表达,同时分析研究组不同X线关节滑液IL-8、IL-17、VEGF表达。结果研究组关节滑液中IL-8、IL-17、VEGF表达高于对照组,差异有统计学意义(P<0.05);Ⅱ级～Ⅳ级膝骨性关节炎患者关节滑液中IL-8、IL-17、VEGF表达水平均高于对照组,且随着临床分级的增高而增加(P<0.05);免疫组化染色显示IL-8、IL-17、VEGF阳性信号均处于细胞质。结论 IL-8、IL-17、VEGF作为炎性细胞因子,为引起滑膜自身炎症的慢性化及持续化关键因素,故联合监测IL-8、IL-17、VEGF能为临床判定膝骨性关节炎病情进展提供信息。
Objective To study the application value of synovial inflammatory cytokines IL-8, IL-17 and VEGF in the clinical diagnosis of knee osteoarthritis. Methods 76 patients with knee osteoarthritis who were treated in our hospital from June 2016 to March 2018 were selected as the study group. At the same time, 30 patients with simple knee meniscus injury who were treated in our hospital at the same time were selected as the control group. The levels of IL-8, IL-17 and VEGF in synovial fluid were compared. At the same time, the expressions of IL-8, IL-17 and VEGF in synovial fluid of patients with different X-ray grading in the study group were analyzed. Results The levels of IL-8, IL-17 and VEGF in synovial fluid of the study group were higher than those of the control group, and the differences were statistically significant(P<0.05). The expression levels of IL-8, IL-17 and VEGF in synovial fluid of patients with grade II-IV knee osteoarthritis were higher than those of the control group, and increased with the increase of clinical grade(P<0.05). The immunohistochemical staining showed that the positive signals of IL-8, IL-17 and VEGF were all in the cytoplasm. Conclusion As inflammatory cytokines, IL-8, IL-17 and VEGF play an important role in the occurrence and progression of knee osteoarthritis. Therefore, combined monitoring of IL-8, IL-17 and VEGF can provide information for clinical determination in the progression of knee osteoarthritis.
Objective To study the application value of synovial inflammatory cytokines IL-8, IL-17 and VEGF in the clinical diagnosis of knee osteoarthritis. Methods 76 patients with knee osteoarthritis who were treated in our hospital from June 2016 to March 2018 were selected as the study group. At the same time, 30 patients with simple knee meniscus injury who were treated in our hospital at the same time were selected as the control group. The levels of IL-8, IL-17 and VEGF in synovial fluid were compared. At the same time, the expressions of IL-8, IL-17 and VEGF in synovial fluid of patients with different X-ray grading in the study group were analyzed. Results The levels of IL-8, IL-17 and VEGF in synovial fluid of the study group were higher than those of the control group, and the differences were statistically significant(P<0.05). The expression levels of IL-8, IL-17 and VEGF in synovial fluid of patients with grade II-IV knee osteoarthritis were higher than those of the control group, and increased with the increase of clinical grade(P<0.05). The immunohistochemical staining showed that the positive signals of IL-8, IL-17 and VEGF were all in the cytoplasm. Conclusion As inflammatory cytokines, IL-8, IL-17 and VEGF play an important role in the occurrence and progression of knee osteoarthritis. Therefore, combined monitoring of IL-8, IL-17 and VEGF can provide information for clinical determination in the progression of knee osteoarthritis.
引文
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[12] 黄飞麒,陈燕梅,姚乃捷,等.兔膝骨性关节炎模型关节液中IL-1、IL-6及TNF-ɑ 水平的影响研究[J].泰山医学院学报,2017,38(12):1364-1366.
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[15] 鲍晓,何成松.糖皮质激素诱发骨质疏松的类风湿关节炎患者血清25-羟维生素D的表达与骨密度的关系[J].中国老年学杂志,2018,38(2):429-431.
[16] 马武开,宁乔怡,陆道敏,等.苗药金乌健骨方对类风湿关节炎滑膜细胞IL-17-STAT3信号影响的研究[J].中国中药杂志,2018,43(3):585-590.
[17] Seeger JB,Schikschneit JP,Schuld C,et al.Instrumented gait analysis in patients with medial osteoarthritis of the knee after mobile-bearing unicompartmental knee arthroplasty[J].The Knee,2018,25(3):392-397.
[18] 姚晓阳,蒋秀娣,马晨芸,等.抗氨甲酰化蛋白抗体检测对类风湿关节炎诊治的临床价值[J].中华检验医学杂志,2018,41(7):77-80.
[19] 张静思,陈鑫苹,陈斌.RF、抗-CCP、AKA及GPI联合检测在类风湿关节炎诊断中的价值[J].重庆医学,2015,44(13):1788-1789,1793.
[20] 吴迎春,依力潘·凯赛尔,孙辉,等.IL-17基因多态性与新疆地区中老年人群骨性关节炎易感性的关系[J].中国老年学杂志,2018,38(9):2122-2124.
[2] 王亮,陈祁青,童培建,等.膝骨性关节炎早期诊断的研究进展[J].中国骨伤,2016,29(3):288-291.
[3] 尹万乐,马利阁,尤笑迎,等.膝骨性关节炎患者关节滑液白细胞介素-1β和肿瘤坏死因子-α的表达及意义[J].中华实验外科杂志,2017,34(9):1593-1595.
[4] 李冰,刘军,肖瑜,等.促炎症因子与骨性关节炎关系的研究进展[J].天津医药,2016,44(3):281-285.
[5] Chen L,Duvvuri B,Grigull J,et al.Experimental evidence that mutated-self peptides derived from mitochondrial DNA somatic mutations have the potential to trigger autoimmunity[J].Hum Immunol,2014,75(08):873-879.
[6] 陈亮,梁津瑜,唐芳,等.白细胞介素17受体A特异性DNA适配子抑制小鼠实验性关节炎滑膜炎症[J].中华关节外科杂志,2015,9(1):78-82.
[7] 陈彪,李斌,陈廖斌.骨关节炎患者血清及关节液中白细胞介素-17表达及其意义[J].临床外科杂志,2015,15(5):340-342.
[8] 徐慧,陆进明.VEGF在骨关节炎发病机制中的研究进展[J].安徽医学,2016,37(7):923-925.
[9] 刘兴振,祝春华,赵东宝,等.巢乱蛋白2及JAK-STAT通路对类风湿关节炎成纤维样滑膜细胞凋亡的影响[J].中华医学杂志,2018,98(15):1189-1193.
[10] Mittal N,Bhandari M,Kumbhare D.Are corticosteroid injections safe to inject into knees with osteoarthritis?What are the long-term effects?[J].Ame J Phys Med Rehabil,2018,97(6):461-464.
[11] 赵甲军,黄遂柱.兔膝关节骨性关节炎半月板形态改变及基质金属蛋白酶-3和金属蛋白酶组织抑制剂-1表达[J].中华实用诊断与治疗杂志,2015,29(6):546-548.
[12] 黄飞麒,陈燕梅,姚乃捷,等.兔膝骨性关节炎模型关节液中IL-1、IL-6及TNF-ɑ 水平的影响研究[J].泰山医学院学报,2017,38(12):1364-1366.
[13] 袁普卫,康武林,刘德玉,等.膝骨性关节炎患者滑膜水通道蛋白-1表达与血管生成的相关性研究[J].中国矫形外科杂志,2015,23(11):1025-1032.
[14] 余志强,王新华,周勇军,等.膝骨性关节炎患者血清相关标志物水平变化及其临床意义[J].国际检验医学杂志,2016,37(10):1417-1419.
[15] 鲍晓,何成松.糖皮质激素诱发骨质疏松的类风湿关节炎患者血清25-羟维生素D的表达与骨密度的关系[J].中国老年学杂志,2018,38(2):429-431.
[16] 马武开,宁乔怡,陆道敏,等.苗药金乌健骨方对类风湿关节炎滑膜细胞IL-17-STAT3信号影响的研究[J].中国中药杂志,2018,43(3):585-590.
[17] Seeger JB,Schikschneit JP,Schuld C,et al.Instrumented gait analysis in patients with medial osteoarthritis of the knee after mobile-bearing unicompartmental knee arthroplasty[J].The Knee,2018,25(3):392-397.
[18] 姚晓阳,蒋秀娣,马晨芸,等.抗氨甲酰化蛋白抗体检测对类风湿关节炎诊治的临床价值[J].中华检验医学杂志,2018,41(7):77-80.
[19] 张静思,陈鑫苹,陈斌.RF、抗-CCP、AKA及GPI联合检测在类风湿关节炎诊断中的价值[J].重庆医学,2015,44(13):1788-1789,1793.
[20] 吴迎春,依力潘·凯赛尔,孙辉,等.IL-17基因多态性与新疆地区中老年人群骨性关节炎易感性的关系[J].中国老年学杂志,2018,38(9):2122-2124.