[1]郭雄飞,王　挺,汤立新.膝骨关节炎患者血浆骨硬化蛋白及关节液YKL-40水平变化及其临床意义[J].新乡医学院学报,2020,37(2):185-188.[doi:10.7683/xxyxyxb.2020.02.020]
　GUO Xiongfei,WANG Ting,TANG Lixin.Clinical significance of the changes of the levels of plasma sclerostin and YKL-40 in joint fluid of patients with knee osteoarthritis[J].Journal of Xinxiang Medical University,2020,37(2):185-188.[doi:10.7683/xxyxyxb.2020.02.020]
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膝骨关节炎患者血浆骨硬化蛋白及关节液YKL-40水平变化及其临床意义
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年2
页码:
185-188
栏目:
临床研究
出版日期:
2020-02-05

文章信息/Info

Title:
Clinical significance of the changes of the levels of plasma sclerostin and YKL-40 in joint fluid of patients with knee osteoarthritis
作者:
郭雄飞; 王　挺; 汤立新
（南阳市中心医院骨科，河南　南阳　473009）
Author(s):
GUO Xiongfei; WANG Ting; TANG Lixin
(Department of Orthopaedics，Nanyang Central Hospital，Nanyang 473009，Henan Province，China)
关键词:
膝骨关节炎; 骨硬化蛋白; YKL-40
Keywords:
knee osteoarthritis; sclerostin; YKL-40
分类号:
R684.3
DOI:
10.7683/xxyxyxb.2020.02.020
文献标志码:
A
摘要:
目的　探讨膝骨关节炎（KOA）患者血浆骨硬化蛋白（SOST）、关节液YKL-40水平变化及其临床意义。方法　选择2015年3月至2019年3月南阳市中心医院收治的125例KOA患者为观察组，91例交叉韧带损伤患者为对照组。采用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）量表评估患者KOA症状严重程度，检测2组患者治疗前血浆SOST、关节液YKL-40水平；比较2组及不同Kellgren-Lawrence（K-L）分级患者血浆SOST、关节液YKL-40水平，分析血浆SOST、关节液YKL-40水平与KOA患者WOMAC评分、K-L分级的相关性，Logistic回归分析血浆SOST、关节液YKL-40水平对KOA的影响。结果　观察组患者血浆SOST水平低于对照组，关节液YKL-40水平高于对照组（P<0.05）。不同K-L分级KOA患者WOMAC 评分及血浆SOST、关节液YKL-40水平比较差异均有统计学意义（P<0.05）。Ⅲ、Ⅳ级KOA患者WOMAC 评分和关节液YKL-40水平显著高于Ⅱ级患者，Ⅳ级KOA患者WOMAC 评分和关节液YKL-40水平显著高于Ⅲ级患者（P<0.05）；Ⅲ、Ⅳ级KOA患者血浆SOST水平显著低于Ⅱ级患者，Ⅳ级KOA患者血浆SOST水平显著低于Ⅲ级患者（P<0.05）。Pearson相关性分析显示，KOA患者血浆SOST水平与WOMAC评分、K-L分级均呈显著负相关（P<0.05），关节液YKL-40水平与WOMAC 评分、K-L分级均呈显著正相关（P<0.05）。Logistic回归分析显示，血浆SOST是KOA的保护性因素，关节液YKL-40是KOA的危险因素（P<0.05）。结论　KOA患者血浆SOST水平降低，关节液YKL-40水平升高；KOA患者血浆SOST水平与病情严重程度呈负相关，关节液YKL-40水平与病情严重程度呈正相关，二者可反映KOA患者关节软骨损伤及症状严重程度，并影响KOA的发生和进展。
Abstract:
Objective　To investigate the clinical significance of the changes of the levels of plasma sclerostin (SOST) and YKL-40 in joint fluid of patients with knee osteoarthritis (KOA).Methods　A total of 125 patients with KOA were selected as the observation group，and 91 patients with cruciate ligament injury admitted to Nanyang Central Hospital from March 2015 to March 2019 were selected as the control group.The severity of KOA was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale.The levels of plasma SOST and YKL-40 in joint fluid were measured before treatment.The levels of plasma SOST and YKL-40 in joint fluid were compared between the two groups and the patients with different Kellgren Lawrence (K-L) grades.The correlation between plasma SOST，YKL-40 level in joint fluid and WOMAC score and K-L grading of KOA patients were analyzed.The effect of the levels of plasma SOST and YKL-40 in joint fluid on KOA was analyzed by logistic regression.Results　Compared with the control group，the level of plasma SOST decreased and the level of YKL-40 in joint fluid increased in the observation group (P<0.05).There were significant differences in WOMAC score，the levels of plasma SOST and YKL-40 in joint fluid among the KOA patients with different K-L grades (P<0.05).The WOMAC score and YKL-40 level in joint fluid in the patients with grade Ⅲ and Ⅳ KOA were significantly higher than those in the patients with grade Ⅱ KOA(P<0.05).The WOMAC score and YKL-40 level in joint fluid in the patients with grade Ⅳ KOA were significantly higher than those in the patients with grade Ⅲ KOA (P<0.05).The level of plasma SOST in patients with grade Ⅲ and Ⅳ KOA was significantly lower than that in patients with grade Ⅱ KOA(P<0.05).The level of plasma SOST in patients with grade Ⅳ KOA was significantly lower than that in patients with grade Ⅲ KOA (P<0.05).Pearson correlation analysis showed that plasma SOST level was significantly negatively correlated with WOMAC score and K-L grading (P<0.05)，and YKL-40 level in joint fluid was significantly positively correlated with WOMAC score and K-L grading in KOA patients (P<0.05).Logistic regression analysis showed that plasma SOST was the protective factor for KOA，and YKL-40 of joint fluid was the risk factor for KOA (P<0.05).Conclusions　In KOA patients，the level of plasma SOST decrease and the level of YKL-40 in joint fluid increase.The level of plasma SOST is negatively correlated with the severity of KOA，and the level of YKL-40 in joint fluid is positively correlated with the severity of KOA.Both of them can reflect the severity of articular cartilage injury and symptoms in patients with KOA，and affect the occurrence and progress of KOA.

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更新日期/Last Update: 2020-02-05