骨关节炎患者滑液中COMP水平与病情严重程度的相关性研究

背景：软骨寡聚基质蛋白（cartilage oligomeric matrix protein，COMP）是软骨中非胶原蛋白的主要成分，软骨的损伤、修复和代谢变化均可能影响COMP的表达水平。目的：研究骨关节炎（osteoarthritis，OA）患者关节滑液中COMP水平与病变严重程度的相关性，探讨注射玻璃酸钠对关节滑液中COMP的影响。方法：52例膝关节0A患者接受关节内注射玻璃酸钠治疗，治疗前、治疗后6个月行X线片检查，按Kellgren放射学诊断标准评级，记录治疗前和治疗开始后5周、6个月时患者膝关节的WOMAC评分。采用ELISA方法测定在接受透明质酸钠治疗前、治疗开始后5周关节液中的COMP水平。19例因半月板或韧带损伤接受关节镜手术的患者作为正常对照组。结果：OA组患者滑液中COMP水平明显高于对照组，有统计学差异（P=0．036）。OA组患者滑液中COMP水平与OA严重程度（WOMAC评分）呈正相关（P=0．001），与影像学Kellgren分级标准无相关性（P=0．12）。结论：滑液中COMP水平与OA病变严重程度呈正相关，测定OA患者血中COMP水平对进一步研究OA发病机理、早期发现并采取有效防治策略及监测防治效果具有极其重要的意义。

Correlation between cartilage oligomeric matrix protein in synovial fluid and the severity of knee osteoarthritis

Background:Cartilage oligomeric matrix protein(COMP) is the main component of cartilage non-collagenous protein.Cartilage injury,repair and metabolic changes that may affect the expression level of COMP.Objective:To investigate the relationship between the levels of COMP in synovial fluid and severity of osteoarthritis.Methods:A total of 52 patients with knee osteoarthritis received intra-articular injections of sodium hyaluronate and were followed up for 6 months.WOMAC score was recorded before treatment,5 weeks and 6 months after treatment.Radiographic findings were evaluated according to the Kellgren-Lawrence grade before treatment and 6 months after treatment.The levels of COMP in synovial fluid were analyzed by enzyme-linked immunosorbent assay(ELISA).Synovial fluid of knee joint was collected from 19 controls(meniscus or ligament injury without cartilage injury under arthroscopy).Results:The levels of COMP in osteoarthritis patients were significantly higher than those in control group(P=0.036).The levels of COMP in synovial fluid was positively correlated with WOMAC score(P=0.001),but not with Kellgren-Lawrence grade(P=0.12).Conclusions:The level of COMP in synovial fluid is related with the severity of osteoarthritis.COMP is a sensitive marker reflecting the metabolic changes of articular cartilage.