HtrA1在骨关节炎早期软骨退变中的诊断价值

摘要

目的：探讨骨关节炎患者关节滑液中HtrA1的表达是否与软骨退变程度相关。方法：研究对象包括膝骨关节炎（KOA）患者40例，其中软骨退变Ⅱ、Ⅲ、Ⅳ级的病例数分别为15、11、14例，正常人28例，应用ELISA测定丝氨酸蛋白酶1（HtrA1）在关节滑液中的表达程度。结果：KOAⅡ、Ⅲ、Ⅳ组中关节滑液的HtrA1因子表达均明显高于正常人，差异有统计学意义（P<0.01），而不同软骨退变程度患者的关节液HtrA1因子表达也不同。KOAⅡ、Ⅲ、Ⅳ组的组间HtrA1因子表达含量比较差异无统计学意义（P>0.05）。正常对照组关节液HtrA1因子表达含量为67.89~208.33 pg/ml，以208.33 pg/ml作为阴性，KOA患者不同程度软骨退变（KOAⅡ、Ⅲ、Ⅳ组）各组检测的敏感度均超过85.7%。结论：HtrA1对早期软骨退变（KOAⅢ级）诊断的敏感度在90%以上，特别是诊断KOA患者KOAⅡ级软骨退变的敏感度最高，可达93%以上。说明HtrA1是诊断早期软骨退变（KOAⅡ级）的良好指标。%Objective:To explore the relationship of HtrA1 expression of synovial fluid in osteoarthritis and the degree of cartilage degeneration. Method:The object of study,including 40 cases of patients with knee osteoarthritis,including cartilage degeneration gradeⅡ,Ⅲ,gradeⅣnumber of cases were 15,11,14,normal 28 cases,the application of ELISA,HtrA1 in synovial fluid the expression level.Result:KOA II,Ⅲ,groupⅣthe synovial fluid HtrA1 factor expression were significantly higher than normal,there was statistically significant(P<0.01),the different cartilage degeneration patients the synovial fluid HtrA1 factor expression were also different.KOAⅡ,Ⅲ,Ⅳgroup group HtrA1 factor expression levels was not statistically significant(P>0.05).Normal control group joint fluid HtrA1 factor expression content to 67.89-208.33 pg/ml,if 208.33 pg/ml as a negative,the sensitivity of KOAⅡ,Ⅲ,Ⅳgroup were more than 85.7%.Conclusion:The HtrA1 early cartilage degeneration(KOA grade III)diagnostic sensitivity of 90%,in particular the diagnosis of patients with KOA KOA class II cartilage degeneration highest sensitivity,more than 93%. The HtrA1 description is a good indicator for the early diagnosis of cartilage degeneration(KOA grade II).