膝骨关节炎患者关节腔注射玻璃酸钠后血清及关节液中可溶性Fas蛋白的变化

背景:关节软骨细胞凋亡在骨关节炎的发病中起重要作用,Fas是肿瘤坏死因子受体家族成员,是细胞凋亡通路中的重要蛋白。目的:观察膝骨关节炎患者血清可溶性Fas蛋白水平的变化以及玻璃酸钠治疗对血清及关节液中可溶性Fas蛋白的影响。方法:选取64例膝骨关节炎患者和48名正常对照者,膝骨关节炎患者再随机分为常规治疗组和玻璃酸钠组。常规治疗组给予常规治疗,玻璃酸钠组在常规治疗的基础上,给予关节腔内注射玻璃酸钠2mL,1次/周,连续5周。检测正常组及膝骨关节炎患者治疗前后血清及关节液中可溶性Fas蛋白水平的变化。结果与结论:与对照组相比,膝骨关节炎患者血清可溶性Fas蛋白水平明显增高,差异有显著性意义。非条件logistic回归分析表明,升高的血清可溶性Fas蛋白水平是膝骨关节炎发病的独立危险因子。治疗5周后,玻璃酸钠组的血清及关节液中的可溶性Fas蛋白水平较治疗前明显下降,差异有显著性意义;而常规治疗组的血清及关节液中的可溶性Fas蛋白水平与治疗前相比无明显变化。提示玻璃酸钠具有降低膝骨关节炎患者血清及关节液中可溶性Fas蛋白水平的作用。

Soluble Fas level changes in serum and synovial fluid of patients with knee osteoarthritis following injection of sodium hyaluronate

BACKGROUND:Apoptosis of articular chondrocytes plays an important role in the progression of osteoarthritis.Fas is an important protein in apoptosis pathway,which is a member of tumor necrosis factor receptor family.OBJECTIVE:To investigate the changes of soluble Fas(sFas) in serum of patients with knee osteoarthritis and the effects of sodium hyaluronate on sFas in serum and synovial fluid.METHODS:Sixty-four patients with knee osteoarthritis and forty-eight healthy controls were enrolled.Patients with knee osteoarthritis were divided into sodium hyaluronate group and regular treatment group randomly.Patients in the regular treatment group were given regular treatment.Patients in sodium hyaluronate group were treated with intra-articular injection of sodium hyaluronate(2 mL,once for 1 week) for 5 weeks based on regular treatment.The levels of sFas in serum and synovial fluid were examined in controls and patients before and after therapy.RESULTS AND CONCLUSION:The serum sFas levels were significantly increased in patients with knee osteoarthritis compared with normal controls.Unconditional logistic regression analysis showed that the increased serum sFas was an independent risk factor of the presence of knee osteoarthritis.After 5 weeks treatment,the sFas levels in serum and synovial fluid were significantly decreased in the sodium hyaluronate group compared with those before treatment.However,there were no significant differences in the sFas levels in serum and synovial fluid of the regular treatment group before and after treatment.Sodium hyaluronate can reduce the sFas levels in serum and synovial fluid of patients with knee osteoarthritis.