膝骨关节炎患者血清血小板反应蛋白-1水平变化及临床意义#br#

目的　探讨膝骨关节炎患者血清中血小板反应蛋白-1（TSP-1）表达的变化及临床意义。方法　选择186例膝骨关节炎患者，依据KL分级标准将患者分为KL 0级组44例、Ⅰ级组52例、Ⅱ级组39例、Ⅲ级组28例、Ⅳ级组23例。另外选取我院健康体检者170例，将其作为对照组。酶联免疫吸附测定（ELISA）试验检测血清中TSP-1水平，分析TSP-1与骨关节炎及临床指标之间的相关性。绘制受试者工作特征（ROC）曲线获得TSP-1预测骨关节炎的最佳临界值。结果　与对照组相比，骨关节炎患者血清TSP-1水平明显升高（P＜0.05）。与KL 0级组的患者相比，KL Ⅰ、Ⅱ、Ⅲ和Ⅳ级组患者血清TSP-1水平显著升高（P＜0.05）。与KL Ⅰ级组患者相比，KⅢ、Ⅳ级组的患者血清TSP-1水平显著升高（P＜0.05）。与KLⅡ、Ⅲ级组的患者相比，KLⅣ级组的患者血清TSP-1水平显著升高（P＜0.05）。血清TSP-1水平与红细胞沉降率（ESR）、血清C反应蛋白（CRP）、软骨寡聚基质蛋白（COMP）、基质金属蛋白酶-13（MMP-13）和转化生长因子-β1（TGF-β1）水平呈正相关。ROC结果示，血清TSP-1诊断骨关节炎的最佳临界值为250.9 μg/L，敏感度为81.1%，特异度为81.9%。结论　骨关节炎患者血清TSP-1水平异常升高，且与骨关节炎的严重程度密切相关。

Changes of serum platelet reactive protein-1 level and its clinical significance in patients with knee osteoarthritis

Objective　To explore the serum expression of thrombospondin-1 (TSP-1) and clinical significance in patients with knee osteoarthritis. Methods　A total of 186 patients with knee osteoarthritis were selected. According to KL classification, the patients were divided into KL 0 group (n= 44), KLⅠgroup (n= 52), KLⅡgroup (n=39), KL Ⅲ group (n= 28) and KL Ⅳ group (n=23). The control group were included 170 healthy people in our hospital. The serum level of TSP-1 was detected by enzyme-linked immunosorbent assay (ELISA), and the correlation between TSP-1 and the severity and clinical indicators of osteoarthritis was analyzed. The subject performance characteristic curve (ROC) was drawn to obtain the optimal threshold value of TSP-1 to predict osteoarthritis. Results　The serum level of TSP-1 was significantly higher in osteoarthritis group than that in control group (P＜0.05). Compared with patients of KL 0 group, the serum TSP-1 levels were significantly higher in KLⅠ, KL Ⅱ, KL Ⅲ and KL Ⅳ groups (P＜0.05). Compared with patients of KLⅠgroup, the serum TSP-1 levels were significantly higher in patients of KL Ⅲ and KL Ⅳ groups (P＜0.05). Compared with patients of KLⅡ and KLⅢgroups, the serum TSP-1 levels were significantly higher in patients of KLⅣgroup (P＜0.05). The serum TSP-1 level was positively correlated with erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), cartilage oligomeric matrix protein (COMP), matrix metalloproteinase-13 (MMP-13) and transforming growth factor-β1 (TGF-β1) levels. The ROC results showed that the optimal threshold of serum TSP-1 for the diagnosis of osteoarthritis was 250.9 μg/L (sensitivity=81.1%, specificity=81.9%). Conclusion　The serum level of TSP-1 is abnormally high in patients withosteoarthritis, which is closely related to the severity of osteoarthritis.