氨基葡萄糖对膝骨关节炎IL-6、VEGF、SOD、MDA影响的临床研究

摘要

目的：观察膝骨关节炎患者关节液中 IL-6、VEGF、SOD 和 MDA 水平的变化，以及盐酸氨基葡萄糖对 IL-6、VEGF、SOD 和 MDA 水平的影响。方法：将76例膝骨关节炎患者随机分为 A 组(常规治疗组)和 B 组(氨基葡萄糖治疗组)，A 组予以常规治疗，B 组在常规治疗基础上口服氨基葡萄糖胶囊，连续治疗8周。A、B 两组患者均停用非甾体类抗炎药2周后，行患膝关节腔穿刺、抽吸滑液。于治疗前、治疗后检测其关节液中 IL-6、VEGF、SOD 和 MDA 的含量，进行疗效评价。结果：A、B 两组患者治疗前，关节液 IL-6、VEGF、SOD 和 MDA 水平比较，差异均无统计学意义(P>0.05)；治疗后，两组 IL-6、VEGF 均明显降低，组间比较差异有统计学意义(P<0.05)。两组 SOD 均明显升高，MDA 均明显降低，组间比较差异有统计学意义(P<0.01)。结论：关节滑液中 IL-6、VEGF 与骨关节炎的发生、发展关系密切，其含量的高低与临床症状呈正相关。关节液中的 SOD 水平较低、MDA 水平升高与骨关节炎的发生、发展及临床症状关系密切。氨基葡萄糖能够减少骨关节炎关节滑液中 IL-6、VEGF 含量，减轻炎症反应，从而改善临床症状，氨基葡萄糖能升高骨关节炎患者关节液中的 SOD 水平，降低 MDA 水平，从而降低 Lequesne 指数，改善临床症状，且作用效果较常规组明显，这可能是盐酸氨基葡萄糖治疗骨关节炎的作用机制之一。%Objective:To observe the change of levels of interleukin-6(IL-6),vascular endothelial growth factor(VEGF),superoxide dismutase(SOD) and malondialdehyde(MDA) in the synovial fluid of patients with knee osteoarthritis,and the effect of Glucosamine on the levers of IL-6,VEGF,SOD and MDA. Methods:76 patients with knee osteoarthritis were randomly divided into group A(regular treatment group) and group B(glucosamine treatment group).The patients in the group A were given regular treatment,while the patients in the group B were treated with regular protocals and Oraling glucosamine capsule for 8 weeks. The patients of two groups were discontinued nonsteroidal anti-inflammatory drugs after two weeks,and punctured and sucked synovial fluid of knee cavity.Before and after the treatment,the levels of IL-6 and VEGF in synovial fluid of the two groups were detected.We evaluated the curative effect according to the results. Results:The levels of IL-6,VEGF,SOD and MDA in two groups were no difference before treatment(P>0.05),while the levels of IL-6 and VEGF were both reduced significantly after treatment,and significantly different between two groups(P<0.05).The level of SOD in two groups were both increased significantly,but the levels of MDA were reduced significantly,and there were significantly different comparing between two groups(P<0.01).Conclusion:The relationship of the levels of IL-6 and VEGF in the synovial fluid and the occurrence and development of osteoarthritis are very closed,the content of IL-6 and VEGF and clinical symptoms are positively correlated.Relationship of the levels of SOD and MDA in the synovial fluid and the occurrence and development of osteoarthritis is very closed,the content of SOD and MDA and clinical symptoms are positively correlated.Glucosamine can reduce the levels of IL-6 and VEGF in the synovial fluid of patients with knee osteoarthritis,alleviate inflammation,so as to improve the clinical symptoms.Glucosamine can increase the level of SOD and reduce the lever of MDA in the synovial fluid of patients with knee osteoarthritis,alleviate inflammation,so as to reduce Lequesne index and improve the clinical symptoms,and the effect of the conventional group is obvious.This may be one of the mechanism of action of glucosamine hydrochloride in osteoarthritis.