【作者】 王拥军；

【导师】 王利民；

【作者基本信息】 郑州大学 ， 外科学， 2009， 硕士

【摘要】 研究背景Ⅱ型胶原是关节软骨的主要结构成分,也存在于椎间盘中且是终板软骨和椎间盘髓核中蛋白质的主要组成成分。Ⅱ型胶原C端肽(CTX-Ⅱ)是Ⅱ型胶原的裂解产物,完全来自成熟的结构性胶原,以小肽形式全部进入尿液。有研究显示,骨性关节炎(Osteoarthritis,OA)患者体内的CTX-Ⅱ水平较健康人显著升高。但CTX-Ⅱ水平与椎间盘退变(Intervertebral disk degeneration,IVDD)的关系国内尚无文献报道。目的探讨CTX-Ⅱ与椎间盘退变及骨性关节炎的相关性及CTX-Ⅱ在椎间盘退变和骨性关节炎患者尿液中含量的差别。方法选择椎间盘退变和骨性关节炎患者各15例分别作为椎间盘退变组和骨性关节炎组,其中椎间盘退变组男7例,女8例,平均年龄(62±7)岁;骨性关节炎组男6例,女9例,平均年龄(61±8)岁;另选未患骨性关节炎及椎间盘退变的非骨科疾病患者15例作为对照组,男8例,女7例,平均年龄(57±6)岁。3组患者分别取第二次晨尿10 mL,尿样置-20℃冰箱保存。尿样收齐后,用人骨退化特异标志物酶联免疫分析试剂盒检测每例标本的Ⅱ型胶原C端肽值,同时用肌酐试剂盒检测每例标本的尿肌酐浓度,并对Ⅱ型胶原C端肽值进行校正。所有数据均应用SPSS10.0统计软件包进行处理,3组患者的CTX-Ⅱ校正值进行统计学正态性分布、方差齐性检验后进行组与组之间单因素方差分析,并分别对椎间盘退变患者及骨性关节炎患者尿中CTX-Ⅱ水平和分级评分进行回归分析,P＜0.05为差异有显著性意义。结果45例患者均进入结果分析。与对照组相比,椎间盘退变组和骨性关节炎组患者尿中Ⅱ型胶原C端肽明显升高,差异有显著性意义(P＜0.05)。椎间盘退变组和骨性关节炎组Ⅱ型胶原C端肽水平相比,差异无显著性意义(P＞0.05)。椎间盘退变组椎间盘退变分级与Ⅱ型胶原C端肽水平呈正相关(r=0.592,P=0.020)。骨性关节炎组膝关节退变分级与Ⅱ型胶原C端肽水平也呈正相关(r=0.719,P=0.003)。结论椎间盘退变患者及骨性关节炎患者尿中Ⅱ型胶原C端肽水平均有升高,且Ⅱ型胶原C端肽与椎间盘退变及骨性关节炎具有正相关性。更多还原

【Abstract】 BackgroundCollagen typeⅡis the major structural component of articular cartilage. It is also the major component of terminal plate and nucleus gelatinosus. Collagen typeⅡC-telopeptide (CTX-Ⅱ) is the split product of collagen typeⅡ. It only generated from ripe structural collagen and ingressed into urine as a small peptide form. Investigation has revealed that the content of urinary CTX-Ⅱin osteoarthritis (OA) patients are higher than health adults. But the relationship between the content of urinary CTX-Ⅱand intervertebral disc degeneration (IVDD) has not reported in the domestic literature yet.ObjectivesTo study the correlation of collagen typeⅡC-telopeptide (CTX-Ⅱ) to intervertebral disc degeneration and osteoarthritis, and to investigate the difference of CTX-Ⅱin the urine of the patient with intervertebral disc degeneration and osteoarthritis.MethodsFifteen patients with intervertebral disc degeneration, including 7 male and 8 female, with mean age of (62±7) years old, and 15 patients with osteoarthritis, containing 6 male and 9 female with mean age of (61±8) years old were selected. In addition, 15 patients (8 male and 7 female) without intervertebral disc degeneration or osteoarthritis, with mean age of (57±6) years old were served as the control group. For each patient, fasting second-void morning urine samples were collected and stored at -20℃. After all the samples were collected, urinary CTX-Ⅱwas measured by enzyme-link immunosorbent assay. Meanwhile, the creatinine concentrations of each sample was detected by creatinine kit for correct the CTX-Ⅱ. All the data were analyzed with SPSS10.0 statistical software. The correction value of CTX-Ⅱwith 3 groups of patients were analyzed by one way analysis of variance after test of normality and homogeneity test for variance. Meanwhile, the content of urinary CTX-Ⅱin intervertebral disc degeneration and osteoarthritis groups were analyzed with the grade of degeneration by regression analysis. P<0.05 was considered the level of significance.ResultA total of 45 patients were included in the final analysis. Compared with the control group, the content of urinary CTX-Ⅱin intervertebral disc degeneration and osteoarthritis groups were higher, and the distinction had statistical significance (P < 0.05). Compared the content of urinary CTX-Ⅱbetween intervertebral disc degeneration group and osteoarthritis group, the distinction had no statistical significance (P > 0.05). There was positive correlation of urinary CTX-Ⅱto the grade of intervertebral disc degeneration and osteoarthritis (r=0.592,0.719;P=0.020,0.003).ConclusionsThe content of urinary CTX-Ⅱstep up both in intervertebral disc degeneration patients and osteoarthritis patients. Urinary CTX-Ⅱhas direct correlation with intervertebral disc degeneration and osteoarthritis.更多还原