亚硫酸盐和雌激素及炎症因子在老年女性膝骨关节炎血清与关节液中的水平及意义

目的探讨亚硫酸盐和雌激素及炎症因子在老年女性骨关节炎患者血清及关节液中的含量变化及其抗炎效应。方法选择住院老年女性患者26例,年龄55～75岁,中位年龄67岁;病史1.8～25.6年,平均10年。均为我科初诊患者,根据骨性关节炎诊断标准确诊为膝骨关节炎,留取治疗前常规关节腔减压治疗时抽吸的关节液,及治疗后复查时的关节液。测定血清雌二醇水平、血清及关节液中的亚硫酸盐及白介素(IL-1、IL-6、IL-8)的含量变化。结果老年女性膝骨关节炎患者的血清雌激素(雌二醇)水平显著低于对照组(P<0.01);急性期血清关节液中亚硫酸盐和炎性因子(IL-1、IL-6和IL-8)均较高,经治疗后恢复期时各值均显著下降(P<0.01)。再根据不同年龄段分组,测定不同年龄段的膝骨关节炎患者急性期血清及关节液中亚硫酸盐和炎症因子(IL-1、IL-6和IL-8)的变化,各炎症因子变化差异无统计学意义(P>0.05);而血清雌二醇水平随年龄增加而减低,差异有统计学意义(P<0.01);急性期骨关节液中亚硫酸盐水平随年龄增加而减低,差异有统计学意义(P<0.01)。随着年龄的增长,骨关节炎患者血清雌二醇水平与关节液中亚硫酸盐含量之间有相关性(R2=-0.991,P<0.05)。结论亚硫酸盐和雌激素及炎症因子共同参与老年女性骨关节炎的发病过程,可能是一种生物活性分子在炎症局部发挥一定的病理生理学作用。

Changes of the levels of sulfite,estrogen and inflammatory factors in serum and synovial fluids in elderly women with knee osteoarthritis

Objective To observe the changes of levels of sulfite,estrogen and inflammatory factors in serum and synovial fluids in elderly female patients with knee osteoarthritis(OA) .Methods 26 elderly female hospitalization patients with OA diagnosed at first visit From August 2008 to August 2010 were enrolled in the investigation,and the patients’ age was between 55～75 years,median age was 67 years,with medical history between 1.8～25.6 years(mean 10 years) .The patients’ synovial fluids were taken out during routine joint cavity decompression treatment before and after treatment,and the levels of serum estradiol,sulfite,interleukins including IL-1,IL-6,IL-8 in serum and synovial fluid were detected simultaneously.Results The levels of serum estrogen(estradiol) in elderly women with OA were significantly lower than those of control group(P<0.01) ,and the levels of sulfite and inflammatory factors including IL-1,IL-6 and IL-8 in serum and synovial fluid at acute period were higher,however,after treatment the levels of these factors at recovery period were significantly decreased(P<0.01) .There were no significant differences in the levels of inflammatory factors including IL-1,IL-6 and IL-8 among different age groups(P>0.05) ,however,the levels of serum estradiol were decreased with the increase of age,and there were significant differences in the levels of serum estradiol among different age groups(P<0.05) .The levels of sulfite in synovial fluid at acute period were decreased with the increase of age,and there were significant differences among different age groups(P<0.01) .With the increase of age,the levels of serum estradiol in patients with OA were correlated with the content of sulfite in synovial fluid(R2=0.991,P<0.05) .Conclusion The sulfite,estradiol and inflammatory factors are jointly involved in the pathogenesis of osteoarthritis in senile female patients,which may be a kind of bioactive molecule that plays certain pathophysiological role in inflammation local area.