膝骨关节炎患者滑膜与关节液中Notch通路相关蛋白变化的意义

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摘要目的探讨膝关节骨关节炎(knee osteoarthritis，KOA)患者滑膜与关节液中Notch通路相关蛋白(Notch1、Notch3、Jagged1、Jagged2、Hes5)的变化水平及意义。方法选取2021年1月至2022年12月重庆医科大学附属大足医院收治的80例膝关节骨关节炎(knee osteoarthritis，KOA)患者为研究对象(KOA组)，另选取同期医院收治的30例半月板损伤患者为对照(对照组)。采用Kellgren-Lawrence(K-L)分级及Lequesne MG量表评价KOA病情严重程度。分别采用酶联免疫吸附试验、免疫组织化学染色检测关节液及滑膜组织中Notch1、Notch3、Jagged1、Jagged2、Hes5表达水平。用受试者工作特征(receiver operating characteristic，ROC)曲线对Notch1、Notch3、Jagged1、Jagged2、Hes5诊断KOA的价值进行分析。结果 KOA组关节液和滑膜组织中Notch1、Notch3、Jagged1、Jagged2、Hes5表达水平均高于对照组，差异均有统计学意义(P＜0.05)。K-L分级越高，关节液和滑膜组织中Notch1、Notch3、Jagged1、Jagged2、Hes5表达水平越高(P＜0.05)。KOA患者关节液和滑膜组织中的Notch1、Notch3、Jagged1、Jagged2、Hes5表达水平分别均与Lequesne MG量表评分呈正相关(P＜0.05)。关节液中Notch1、Notch3、Jagged1、Jagged2、Hes5对KOA诊断的曲线下面积(area under curve，AUC)分别为0.563、0.786、0.600、0.453、0.543，5指标联合的AUC为0.710；滑膜组织中Notch1、Notch3、Jagged1、Jagged2、Hes5对KOA诊断的AUC分别为0.467、0.671、0.572、0.551、0.456，5指标联合的AUC为0.787；将关节液、滑膜组织中Notch1、Notch3、Jagged1、Jagged2和Hes5共同进行联合，AUC为0.845。结论 KOA患者滑膜及关节液中Notch通路发生异常变化，Notch通路相关蛋白(Notch1、Notch3、Jagged1、Jagged2、Hes5)的检测有助于诊断KOA并评估病情严重程度。

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	李伟
	黄耀凯
	王洪林
	汪礼军
	黄珍谷
	陈兴华
	刘剑

关键词 ：膝关节骨关节炎, Notch通路, 诊断, 滑膜, 关节液

Abstract：Objective To investigate the changes and significance of Notch pathway related proteins (Notch1，Notch3，Jagged1，Jagged2，Hes5) in synovium and synovial fluid of patients with knee osteoarthritis (KOA).Methods 80 patients with KOA admitted to Dazu Hospital Affiliated To Chongqing Medical University from January 2021 to December 2022 were selected as the study object (KOA group)，and 30 patients with meniscus injury admitted to our hospital in the same period were selected as the control group (control group).The severity of KOA was evaluated with Kelgren-Laurence (K-L) grading and Lequesne MG scale score.The expression levels of Notch1，Notch3，Jagged1，Jagged2，Hes5 in joint fluid and synovial tissue were detected by enzyme-linked immunosorbent assay and immunohistochemical staining respectively.The value of Notch1，Notch3，Jagged1，Jagged2，Hes5 in the diagnosis of KOA was analyzed with the subject’s working characteristic curve (ROC).Results The expression levels of Notch1，Notch3，Jagged1，Jagged2，and Hes5 in the joint fluid and synovial tissue of the KOA group were significantly higher than those in the control group (P＜0.05).The higher the K-L grade，the greater the expression levels of Notch1，Notch3，Jagged1，Jagged2，and Hes5 in the synovial fluid and synovial tissue (P＜0.05).Additionally，the expression levels of Notch1，Notch3，Jagged1，Jagged2，and Hes5 in the synovial fluid and synovial tissue of KOA patients positively correlated with the Lequesne MG scale scores (P＜0.05).The AUC values for the diagnosis of KOA using Notch1，Notch3，Jagged1，Jagged2，and Hes5 in the joint fluid were 0.563，0.786，0.600，0.453，and 0.543，respectively，while the AUC for the combination of all five markers was 0.710.In synovial tissue，the AUC values for the same markers were 0.467，0.671，0.572，0.551，and 0.456，respectively，with a combined AUC of 0.787.When combining the markers in both joint fluid and synovial tissue，the AUC reached 0.845.Conclusion The Notch pathway in the synovium and synovial fluid of KOA patients exhibits abnormal changes.The detection of Notch pathway-related proteins，including Notch1，Notch3，Jagged1，Jagged2，and Hes5，is beneficial for diagnosing KOA and assessing the severity of the disease.

Key words： knee osteoarthritis Notch pathway diagnosis synovial membrane synovial fluid

基金资助:重庆市大足区2022年科卫联合医学科研项目(DZKJ2022JSYJ-KWXM1018)

通讯作者: 刘剑

作者简介: 李伟(1988－ )，男，主治医师，重庆医科大学附属大足医院骨科，wotunx93139@163.com

引用本文:

李伟，黄耀凯，王洪林，汪礼军，黄珍谷，陈兴华，刘剑. 膝骨关节炎患者滑膜与关节液中Notch通路相关蛋白变化的意义[J]. 实用骨科杂志, 2024, 30(5): 424-.
Li Wei，Huang Yaokai，Wang Honglin，Wang Lijun，Huang Zhengu，Chen Xinghua，Liu Jian. The Significance of Changes in Notch Pathway Related Proteins in Synovium and Synovial Fluid of Patients with Knee Osteoarthritis. sygkzz, 2024, 30(5): 424-.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2024/V30/I5/424

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