中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (26): 4778-4782.doi: 10.3969/j.issn.1673-8225.2010.26.007

• 人工假体 artificial prosthesis • 上一篇    下一篇

关节置换与关节镜下清理术后膝骨性关节炎患者尿液EKGPDP小肽与关节软骨退变的相关性

林奇生1，肖德明2，彭建强1，蔡汉周1，马树强1，巫卫东1   

  1. 1深圳市第四(福田)人民医院(广东医学院附属深圳福田医院)骨关节外科，广东省深圳市　518033；
    2深圳市第二人民医院骨科，广东省深圳市　518035
  • 出版日期:2010-06-25 发布日期:2010-06-25
  • 作者简介:林奇生，男，1973年生，江西省南康市人，汉族，2008年暨南大学毕业，硕士，主治医师，主要从事关节外科，关节微创(关节镜)外科方面的研究。 Brainylin@163. com
  • 基金资助:

    深圳市科技局项目(200903208)；
    深圳市福田区公益项目(FTWS028)

Correlation between urinary EKGPDP peptide level and cartilage degradation in knee osteoarthritis patients following knee replacement or arthroscopic debridement

Lin Qi-sheng1, Xiao De-ming2, Peng Jian-qiang1, Cai Han-zhou1, Ma Shu-qiang1, Wu Wei-dong1   

  1. 1Department of Orthopaedics, Fourth People’s Hospital of Shenzhen (Futian Hospital, Guangdong Medical University), Shenzhen  518033, Guangdong Province, China; 2Department of Orthopaedics, Second People’s Hospital of Shenzhen, Shenzhen  518035, Guangdong Province, China
  • Online:2010-06-25 Published:2010-06-25
  • About author:Lin Qi-sheng, Master, Attending physician, Department of Orthopaedics, Fourth People’s Hospital of Shenzhen (Futian Hospital, Guangdong Medical University), Shenzhen 518033, Guangdong Province, China Brainylin@163.com
  • Supported by:

    a Grant from Shenzhen Science and Technology Bureau, No. 200903208*;
    Public Welfare Program of Shenzhen Futian District, No. FTWS028*

PDF

413

被引次数

13

摘要：

背景：目前诊断骨性关节炎的手段主要有影像学和关节镜检查，但都存在一定的局限性。寻找一种特异性、敏感性、诊断率高，可操作性强的诊断方式是目前急需解决的问题。
目的：探讨膝骨性关节炎患者尿液中EKGPDP小肽水平与关节软骨病变严重程度之间的关系。
方法：纳入2006-01/2008-04在广东医学院附属深圳福田医院骨关节外科行关节镜下关节清理术治疗患者45例，膝关节置换术患者15例。纳入同一时期性别年龄相匹配的40名健康志愿者为对照组。采用竞争性ELISA法检测受试者尿液中EKGPDP小肽水平并于半年后复查，以Ayral关节镜膝滑膜炎评分法和Outerbridge软骨损伤评分法评估膝骨性关节炎患者滑膜和关节软骨的病理变化程度。
结果与结论：膝骨性关节炎患者EKGPDP小肽水平明显高于健康人(P < 0.001)。膝骨性关节炎患者的EKGPDP小肽水平与Outerbridge软骨损伤评分、体质量指数正相关；与Ayral膝滑膜炎评分无相关性(P > 0.05)。全膝关节置换术者半年后EKGPDP小肽水平，较置换前明显下降(P < 0.05)，关节镜清理术患者EKGPDP小肽水平变化不明显(P > 0.05)。说明膝骨性关节炎患者尿液中EKGPDP小肽水平可以反映膝关节软骨损伤程度，可为膝骨性关节炎的临床诊断提供依据。

关键词: 骨性关节炎, EKGPDP小肽, 关节镜检查, 尿液, 诊断, 骨组织工程

Abstract:

BACKGROUND: Current approaches for diagnosis of osteoarthritis include imaging and arthroscopy. However, both of them have some limitations. Therefore, a specific, sensitive, high diagnostic rate and operable method is needed.
OBJECTIVE: To explore the relationship between the level of EKGPDP peptide in urine and the severity of cartilage degradation in knee osteoarthritis patients. 
METHODS: A total of 60 patients with knee osteoarthritis (KOA), including 45 undergoing joint debridement and 15 undergoing knee replacement, were selected from Department of Orthopaedics, Fourth People’s Hospital of Shenzhen (Futian Hospital, Guangdong Medical University) between January 2006 and April 2008. In addition, 40 healthy volunteers were selected as controls. The EKGPDP peptide concentration in urine was measured with competitive enzyme-linked immunoassay (ELISA). The pathologies of the synovium and cartilage in knee osteoarthritis were observed with arthroscopy; the degree of synovitis and cartilage degradation under arthroscopy was graded with Ayral’s score system and Outbridge’s score system, respectively.
RESULTS AND CONCLUSION: EKGPDP peptide level in KOA was greater than control group (P < 0.001). The EKGPDP peptide level in KOA was correlated positively with Outbridge’s score and body mass index (P < 0.001), but had no correlation with accumulative Ayral’s score (P > 0.05). Half a year after total knee replacement, the level of EKGPDP peptide decreased significantly (P < 0.05); arthroscopic debridement remained unchanged (P > 0.05). The EKGPDP peptide level in urine can reflect the degree of cartilage degradation, and it is a sensitive marker for the diagnosis of KOA.

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