吉林大学学报(医学版)

• 基础研究 • 上一篇    下一篇

骨关节炎患者关节镜清理术前后关节液中uPA、MMP-3、MMP-9、MMP-13和MMP-14表达水平的检测及其意义

王维山1,2,史晨辉1,2,李长俊1,张振东1,陈安民2,郭风劲2   

  1. 1.新疆石河子大学医学院附属医院骨科,新疆 石河子 832008； 2.华中科技大学同济医学院附属同济医院骨科，湖北 武汉 430030
  • 收稿日期:2013-09-23 出版日期:2014-05-28 发布日期:2014-06-05
  • 通讯作者: 郭风劲(Tel:027-83668231，E-mail:fjguo@tjh.tjmu.edu.cn) E-mail:fjguo@tjh.tjmu.edu.cn
  • 作者简介:王维山(1975-)，男，宁夏回族自治区西吉县人，副主任医师，在读医学博士，主要从事骨关节疾病基础与临床研究。
  • 基金资助:

    国家自然科学基金资助课题（81160225,81260453,81360451）；新疆兵团医药卫生专项资助课题（2013BA020）；兵团国际交流与合作专项资助课题（2012BC002，2011BC004）

Detection of uPA，MMP-3，MMP-9，MMP-13，and MMP-14 expression levels in synovial fluid of OA patients before and after arthroscopic debridement and its significance

WANG Wei-shan 1,2,SHI Chen-hui 1,2,LI Chang-jun1,ZHANG Zhen-dong1,CHEN An-min2,GUO Feng-jing2    

  1. 1. Department of Orthopaedics,Affiliated Hospital,School of  Medical Sciences,Shihezi University,Shihezi 832008,China; 2. Department of Orthopaedics,Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China
  • Received:2013-09-23 Online:2014-05-28 Published:2014-06-05

PDF (PC)

242

赞

摘要：

目的：检测骨关节炎(OA)患者关节镜清理术前后关节液中尿激酶型纤溶酶原激活物(uPA)和基质金属蛋白酶（MMP）-3、MMP-9、MMP-13、MMP-14的表达水平，探讨关节清理手术对uPA、MMP-3、MMP-9、MMP-13和MMP-14表达的影响。方法：收集行关节镜诊治的膝OA患者关节液标本420份，术后半年随访时获取关节液标本350份，对符合本实验条件的228份标本应用ELISA法检测uPA、MMP-3、MMP-9、MMP-13和MMP-14的表达水平，比较术前术后uPA、MMP-3、MMP-9、MMP-13和MMP-14表达水平差异，采用Spearman相关分析探讨uPA、MMP-3、MMP-9、MMP-13和MMP-14与关节疼痛评分(VAS)之间的相关性。结果:所有患者均经临床随访6～70个月，平均随访时间36.5个月。与术前比较，术后半年时OA患者关节液中uPA和MMP-3表达水平明显降低(P<0.01)，MMP-9和MMP-13略有下降(P<0.05)，而MMP-14表达水平无明显变化(P>0.05)；术前uPA、MMP-3、MMP-9、MMP-13和MMP-14表达水平与VAS评分均呈正相关关系（r=0.361、r=0.417、r=0.136、r=0.514和r=0.156，P<0.05）；术后uPA与MMP-3表达水平呈正相关关系（r=0.814，P<0.05），uPA和MMP-3表达水平与VAS评分均呈正相关关系（r=0.981、r=0.831，P<0.01），MMP-13表达水平与VAS评分亦呈正相关关系（r=0.145，P<0.05），而MMP-9和MMP-14表达水平与VAS评分无相关关系（P>0.05）。结论：关节镜清理术能显著减轻患者关节疼痛症状，其作用机制可能与关节液中uPA、MMP-3和MMP-13表达水平下
降有关。

关键词: 骨关节炎, 关节镜手术, 尿激酶型纤溶酶原激活物, 基质金属蛋白酶, 疼痛

Abstract:

Objective To detect the expression levels of urokinase-type plasminogen activator(uPA)，matrix metalloproteinase-3 (MMP-3),MMP-9,MMP-13 and
MMP-14 in the patients with osteoarthritis(OA) before and after arthroscopic debridement,and to explore the influence of arthroscopic debridement in the expressions of uPA,MMP-3,MMP-9,MMP-13,and MMP-14.Methods 420 cases of synovial fluid from knee OA patients undergoing arthroscopic debridement  were obtained before operation.After six months follow-up,350 cases of synovial fluid samples were obtained and according to inclusion and exclusion criteria,228 synovial fluid were selected to analyze.The expression levels of uPA,MMP-3,MMP-9,MMP-13, and MMP-14 were measured by ELISA assay.Pain intensity of these patients before operation and  six months after operation were recorded using the Visual Analogue Scale/Score(VAS).The differences of the expression levels of uPA,MMP-3,MMP-9,MMP-13,and MMP-14 between before operation and after operation were compared.The relationship between the expression levels of uPA,and MMP-3,MMP-9,MMP-13,MMP-14 and VAS was analyzed with Spearman analysis.Results All the patients were followed up for 36.5 months.Compared with before operation,the expression levels of uPA and MMP-3  in the synovial fluid of the patients  after arthroscopic debridement  were significantly decreased(P<0.01),the expression levels of MMP-9  and  MMP-13 were also decreased (P<0.05）,but  the MMP-14 expression level showed no significant change. The expression levels of  uPA,MMP-3,MMP-9,MMP-13,MMP-14  were positively associated with VAS before arthroscopic debridement r=0.361,r=0.417,r=0.136,r=0.514,r=0.156,P<0.05);uPA and MMP-3 were positively correlated with VAS  after arthroscopic debridement（r=0.981，r=0.831，P<0.01），as well as the expression level of MMP-13 and VAS,but there were no significant differences between the expression levels of MMP-9,MMP-14 and VAS.Conclusion The decreased levels of uPA, MMP-3 and MMP-13 in synovial fluid may contribute to the pain-relief effects of arthroscopic debridement.

Key words:  osteoarthritis, arthroscopic debridement, urokinase-type plasminogen activator, matrix metalloproteinase, pain

中图分类号: 

  • R684.3 
版权所有 © 《吉林大学学报(医学版)》编辑部
地址：长春市新民大街828号(130021)　电话：+86-431-85619279　E-mail: xuebao@jlu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发