目的:研究膝关节骨性关节炎患者脊柱-骨盆-下肢矢状面参数与血清及关节液中病情相关分子的关系.方法:选择选择2013年5月~2016年12月期间在东莞市塘厦医院诊断为膝关节骨性关节炎的65例患者作为研究的OA组,同期接受修复手术的70例半月板、交叉韧带损伤患者作为对照组.行立位全脊柱侧位片并测量脊柱-骨盆-下肢矢状面参数,取血清并测定炎症因子含量,取关节液并测定炎症因子含量及细胞凋亡分子表达量.结果:OA组患者的患侧骨盆股骨角(PFA)、骶骨股骨角(SFA)水平显著低于健侧,股骨前倾角(FI)、脊柱前倾角(ST)水平显著高于健侧;OA组患者血清中肿瘤坏死因子(TNF)-α、白介素(IL)-1β、IL-18、基质金属蛋白酶(MMP)1、MMP3的含量显著高于对照组且与PFA、SFA水平呈负相关,与FI、ST水平呈正相关;OA组患者关节液中TNF-α、IL-1β、IL-18、MMP1、MMP3、Fas、FasL、Caveolin-1、NO、CHOP、GRP78的含量显著高于对照组且与PFA、SFA水平呈负相关,与FI、ST水平呈正相关.结论:脊柱-骨盆-下肢矢状面参数能够用于膝关节骨性关节炎患者病程中炎症反应、细胞凋亡的评估.%Objective: To study the relationship between the sagittal parameters of spine-pelvis-lower extremity and disease related molecules in serum and synovial fluid in patients with knee osteoarthritis.Methods: A total of 65 cases patients diagnosed as knee osteoarthritis in Dongguan Tangxia hospital during May 2013-December 2016 were collected as OA group, 70 cases of meniscus and cruciate ligament injury patients underwent repair surgery were collected as the control group.Spine-pelvis-lower extremity parameters were measured by standing spine lateral radiographs.The serum was collected and inflammatory factors contents were measured.The joint fluid was collected and and the expression of inflammatory factors and the expression of apoptotic molecules were measured.Results: Ipsilateral PFA and SFA of OA group patients were significantly lower than the healthy side, FI and ST were significantly higher than that of the healthy side;serum TNF-α and IL-1β, IL-18, MMP1, MMP3 contents of OA group were significantly higher than control group and negatively correlated with PFA, SFA levels, positively correlated with FI and ST level positive;TNF-α and IL-1β, IL-18, MMP1, MMP3, Fas, FasL, Caveolin-1, NO, CHOP, GRP78 contents in synovial fluid of OA group were significantly higher than control group and negatively correlated with PFA, SFA levels, positively correlated with FI and ST level positive.Conclusions: Sagittal parameters of spine-pelvis-lower extremity can be used to evaluate the inflammatory response and apoptosis in patients with knee osteoarthritis.
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