维生素K2联合维生素D3治疗青壮年早期膝骨关节炎的研究

目的探讨维生素K2联合维生素D3治疗青壮年早期膝骨关节炎的作用。 方法2016年1月至2017年6月广州医科大学附属第二医院骨外科门诊因膝关节疼痛的患者共387例。符合早期膝骨关节炎(KOA)的青壮年患者132例，均给予相同剂量的维生素K2和维生素D3(VD)口服，随访6个月，通过观察服药前后血清25-OH-VD、血清总Ⅰ型胶原氨基端延长肽(P1NP)检测、视觉模拟评分(VAS)及股四头肌肌力的比较，维生素K2和维生素D3治疗前后各指标采用配对t检验评价治疗效果。 结果随访6个月后，血清25-OH-VD(t ＝ 2.664)、血清P1NP(t＝3.265 )的水平及股四头肌肌力(最大肌力t ＝3.005；平均肌力t ＝2.564)均较用药前增加(均为P<0.05)，总体VAS评分较用药前下降( t＝3.762，P<0.05)。同时治疗前发现其中33例患者膝关节MRI检查中提示胫骨平台或股骨内侧髁存在不同程度的软骨丢失和骨髓水肿。 结论维生素K2和维生素D3联合应用能改善青壮年膝骨关节炎患者的骨营养代谢，并促进成骨作用从而改善膝关节疼痛症状和活动能力。因此对于青壮年KOA，应该早期干预治疗，从而起到抑制作用。

Effect of Vitamin K2 combined with Vitamin D3 on young patients of early osteoarthritis of knee

ObjectiveTo explore the clinical effect of vitamin K2 combined with vitamin D3 on the young patients of early osteoarthritis of the knee. MethodsFrom January 2016 to June 2017, 387 cases of young patient with pain of the knee were chosen in our hospital. And then according to the inclusive criteria, 132 cases were asked to take both vitamin K2(VK) and vitamin D3(VD) for 6 months. 25-OH-VD, procollagenⅠN-terminal peptide (P1NP) of the serum, VAS score and the muscle strength of four biceps femoris were the research objects before and after treatment. ResultsAfter six months, 25-OH-VD, P1NP of the serum and the muscle strength of four biceps femoris were increased with statistical significance before treatment (P<0.05), while the VAS scores were decreased with statistical significance before treatment (P<0.05). And 33 cases were suggested with loss of cartilages and bone edema in the tibia and femur under X-ray and MRI before treatment. ConclusionVK2 combined with VD3 could release the pain and improve the activity of the young patients of early osteoarthritis of the knee properly through bone metabolism and osteogenesis. The young patients of early osteoarthritis of the knee should get enough intervention as soon as possible.