膝关节液透明质酸含量与滑膜炎程度的关系

目的探讨膝关节液透明质酸含量与滑膜炎程度之间的关系。方法酶联免疫吸附试验(ELISA)检测膝关节疾病(OA)患者102例共104膝的关节液透明质酸含量,并在关节镜下应用Ayral滑膜炎评分法和Outerbridge关节软骨损伤评分法评价膝滑膜炎和关节软骨损伤程度。采用t'检验、Spearman相关分析和多元线性回归分析进行统计分析。结果Ayral滑膜炎评分≥60分组的关节液透明质酸含量比Ayral滑膜炎评分<60分组高(P<0.001)。104膝关节液透明质酸含量与Ayral滑膜炎评分呈正相关(茁'A=0.497,P<0.001),与Outerbridge软骨损伤累计评分呈负相关(茁'o=-0.364,P<0.001),且Ayral滑膜炎评分的影响较大。关节液透明质酸含量与Ayral滑膜炎评分在Ayral滑膜炎评分≥60分组呈正相关(r=0.306,P<0.05),在Ayral滑膜炎评分<60分组无相关性(r=-0.144,P>0.05)。与非OA组相比,OA组的关节液透明质酸含量较低(P<0.05),而Ayral滑膜炎评分较高(P<0.01)。结论膝关节液透明质酸可作为生物标记物反映滑膜炎的程度,关节液透明质酸含量的增高提示滑膜炎较重。

The relationship of hyaluronic acid level in knee joint fluid with the degree of synovitis

Objective To explore the relationship of hyaluronic acid level in knee joint fluid with the degree of synovitis. Methods A total of 104 knees in 102 patients with knee osteoarthritis (OA) or other knee diseases was studied.The hyaluronic acid level in the synovial fluid of the knees was measured with enzyme linked immunoassay.The pathologies of the synovium and articular cartilage were observed with arthroscopy;and degree of synovitis,and cartilage injury under arthroscopy was graded with Ayral′s score system for evaluation of the synovitis,and Outerbridge′s score system for cartilage injury.The data were analyzed by t′-test,Spearman correlation and multiple linear regression.Results The results showed that the hyaluronic acid level in the synovial fluid of the knees was higher in those with Ayral′s score≥60 than in those with the score<60 (P<0.001).The hyaluronic acid level in the synovial fluid of the knees correlated positively with Ayral′s score (狻鋙=0.497,P<0.001) and negatively with accumulative Outerbridge′s score ( 狻鋙=-0.364, P<0.001),especially Ayral′s synovitis score in 104 cases.The hyaluronic acid level in the synovial fluid of the knees correlated positively with Ayral′s score in those with Ayral′s score≥60 (r=0.306,P<0.05),but had no correlation in those with Ayral′s score<60 (r=-0.144,P>0.05). Compared with other knee diseases,the hyaluronic acid level in the synovial fluid of OA knees was lower (P<0.05), Ayral′s score was higher in OA knees (P<0.001).Conclusion The hyaluronic acid level in the synovial fluid of the knee can reflect the degree of synovitis.The synovitis is more severe when hyaluronic acid level in synovial fluid of the knee increases.