关节镜下清理术与透明质酸钠关节内注射治疗膝骨关节炎

doi:吉林省卫生厅资助课题（199903）

关节镜下清理术与透明质酸钠关节内注射治疗膝骨关节炎

康建国^1,2，王明礼^1*，张晓南³

1. 吉林大学第二医院骨科，吉林长春130041；2. 北京电力医院骨科，北京100073；3.吉林大学第一医院骨科，吉林长春130021

收稿日期:2004-02-28 修回日期:1900-01-01 出版日期:2005-09-28 发布日期:2005-09-28
通讯作者: 王明礼

Treatment of knee osteoarthritis with arthroscopic debridement and intra-articular sodium hyaluronate injection

KANG Jian-guo^1,2, WANG Ming-li^1*，ZHANG Xiao-nan³

1. Department of Orthopedics, Second Hospital,Jilin University 130021,China;2. Department of Orthopedics,Beijing Power Hospital,Beijing 100073,China;3. Department of Orthopedics,First Hospital,Jilin Univeristy,Changchun 130021,China

Received:2004-02-28 Revised:1900-01-01 Online:2005-09-28 Published:2005-09-28
Contact: WANG Ming-li

摘要/Abstract

摘要： 目的：探讨关节镜下清理术（arthroscopic debridement， AS）和透明质酸钠关节内注射(intra-articular sodium hyaluronate injection，SHI)治疗膝骨关节炎(KOA)的临床疗效，以及治疗前后血清和关节液中IL-1和NO水平的变化。方法：将轻、中度KOA患者69例，随机采用AS组32例（41膝）和SHI组37例（48膝）治疗，并收集治疗前后血清和膝关节液测定IL-1和NO。膝关节功能用Lysholm评分。IL-1测定为常规ELSIA法，NO测定用硝酸还原酶法。结果：AS和SHI治疗后随访1年，每组Lysholm评分与治疗前比较均有提高，差异均有显著性（P<0.05），AS治疗组的优良率（78.0%）显著高于SHI治疗组（58.3%）；每组治疗后关节液和血清中IL-1、NO水平均较治疗前降低，两组比较差异亦有显著性（P<0.05）。结论：AS和SHI均能使患膝Lysholm的功能评分较治疗前提高，均能降低关节液和血清中炎性介质浓度，都是KOA的有效治疗方法；但在KOA功能改善方面AS更优于SHI。

关键词: 关节镜检查, 透明质酸钠, 白细胞介素1, 一氧化氮

Abstract: Objective To study the curative effect of arthroscopic debridement (AS) and intra-articular sodium hyaluronate injection for patients suffering from knee osteoarthritis (KOA) and explore their influences on the levels of interleukin-1 (IL-1) and nitric oxide(NO) in serum and synovial fluid. Methods 69 patients with grade Ⅰ to grade Ⅲ KOA were randomly divided into AS group (n=32) and SHI group (n=37). All of the cases were estimated by Lysholm scoring scale pre-intervetion and 1 year post-intervetion,and then serum and synovial fluid were collected to detect the levels of IL-1 and NO before and after therapy,respectively, with Nitrate reductase and enzyme-linked immuneoabsordent assay (ELISA). Results Lysholm scores in the two groups were significantly different between pre-operation and post-operation (P<0.05),and the rate of satisfaction one year post-operation in AS group was 78.0%, superior to 58.3% in SHI group.In addition,before therapy,levels of IL-1 and NO in synovial fluid were obviously higher than those in serum in KOA patients (P<0.05). There were significant differences of levels of IL-1 and NO in serum and synovial fluid between pre-operation and post-operation (P<0.05). Conclusion Both AS and SHI can increase the Lysholm score in KOA patlents,decrease the levels of IL-1 and NO in serum and synovial fluid. AS is superior to SHI in functional improvement.

Key words: arthroscopy, sadium hyaluronate, interleukin-1, nitric oxide

中图分类号:

R684

康建国，王明礼，张晓南. 关节镜下清理术与透明质酸钠关节内注射治疗膝骨关节炎[J]. J4, 2005, 31(5): 802-805.

KANG Jian-guo, WANG Ming-li，ZHANG Xiao-nan. Treatment of knee osteoarthritis with arthroscopic debridement and intra-articular sodium hyaluronate injection[J]. J4, 2005, 31(5): 802-805.

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