【摘要】 目的 评估软骨合成降解中的生物标志物在膝骨关节炎(OA)早期诊断和疾病进展中的临床意义。方法 收集神木市医院门诊及住院部确诊的膝OA患者227例作为膝OA组，选取同期健康体检者178例作为对照组。酶联免疫吸附法检测血清ⅡA型前胶原N端前肽(PⅡANP)、软骨寡聚基质蛋白(COMP)、基质金属蛋白酶-3(MMP-3)和尿Ⅱ型胶原交联C端肽(CTX-Ⅱ)水平，双膝X线正侧位片和SF-36简明健康调查问卷分别评估膝OA受累程度和生活质量。结果 1)与对照组相比，膝OA组血清PⅡANP水平降低，血清COMP、MMP-3和尿CTX-Ⅱ水平均升高(P<0.05);2)中晚期膝OA组血清PⅡANP低于早期膝OA组及对照组(P<0.05),血清COMP、MMP-3(P<0.05)和尿CTX-Ⅱ均高于早期膝OA组及对照组；3)膝OA组血清PⅡANP水平与K-L分级呈反相关(P<0.05),血清COMP和MMP-3水平与K-L分级呈正相关(P<0.05),血清COMP水平还与年龄呈正相关(P<0.05)。血清PⅡANP水平与精神健康呈反相关(P<0.05);血清COMP水平与生理功能呈反相关(P<0.05),与精神健康呈正相关(P<0.05)。结论 血清PⅡANP、COMP、MMP-3和尿CTX-Ⅱ在膝OA中表达异常，并随疾病严重程度增加而变化，可作为膝OA诊断和疾病进展的参考指标。更多还原

【Abstract】 Objective To evaluate the clinical significance of biomarkers of cartilage synthesis and degradation for early diagnosis and prognosis of knee osteoarthritis(OA). Methods Two hundred and twenty-seven knee OA outpatients and inpatients in Shenmu Hospital were collected as the knee OA group, while 178 healthy physical examiners as the control group during the same period. Serum pro-collagen ⅡA N-teminal peptide(PⅡANP),cartilageoligomeric matrix protein(COMP), matrix metalloproteinase(MMP-3), and urinary cross-linked C-telopeptide(CTX-Ⅱ)were measured by enzyme-linked immunosorbent assay. The degree of knee OA involvement and quality of life were assessed by antero-posterior and lateral radiographs of both knees and the SF-36 brief health questionnaire, respectively. Results 1)Compared with the control group, the serum PⅡANP level decreased and serum COMP, MMP-3 as well as urinary CTX-Ⅱ increased in the knee OA group(P<0.05). 2)Serum PⅡANP was lower(P<0.05), serum COMP, MMP-3(P<0.05) and urinary CTX-Ⅱ levels were higher in mid-late stage knee OA group than early knee OA group and control group. 3)Serum PⅡANP levels were inversely correlated with K-L grade(P<0.05), serum COMP and MMP-3 levels were positively correlated with K-L grade(P<0.05), and serum COMP level was positively correlated with age(P<0.05). Serum PⅡANP level was negatively correlated with mental health dimension in the SF-36 scale(P<0.05); serum COMP level was negatively correlated with physical function dimension(P<0.05) but positively correlated with mental health dimension(P<0.05). ConclusionsThe expression of PⅡANP, COMP, MMP-3 and CTX-Ⅱ is abnormal in knee OA and related to the progress of the severity of the disease, so is a potential reference index for the diagnosis and prognosis of knee OA.更多还原