血清软骨寡聚基质蛋白水平与膝骨关节炎发生发展的关系研究

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摘要目的分析血清软骨寡聚基质蛋白(cartilage oligomeric matrix protein，COMP)水平与膝骨关节炎(knee osteoarthritis，KOA)发生发展的相关性。方法选取2012年4月至2019年3月期间在上海交通大学医学院附属新华医院崇明分院骨科收治的双侧KOA患者255例(KOA组)作为研究对象，另选取同期来院体检的健康志愿者100例作为对照组。KOA组男168例，女87例；年龄28～85岁，平均年龄(59.77±11.01)岁。对照组男67例，女33例；年龄20～86岁，平均年龄(58.96±12.42)岁。采用酶联免疫吸附法检测血清COMP水平。采用Kellgren-Lawrence(K/L)分级、西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities，WOMAC)骨关节炎指数及Lequesne指数评估KOA疾病严重程度。结果 KOA组患者血清COMP水平显著高于对照组(P＜0.001)。经受试者工作特征曲线分析，血清COMP诊断KOA的曲线下面积为0.789。血清COMP高水平组患者吸烟史概率、疼痛持续时间及Ⅲ型前胶原氨基末端肽(PⅢNP)表达均高于低水平组，而站起走计时测试(TUG)时间低于低水平组(P＜0.05)。经Spearman秩相关分析，KOA患者血清COMP水平与WOMAC、Lequesne指数、K/L分级均呈正相关(r＝0.195，0.393，0.481，P＜0.05)。经多变量Logistic回归分析，血清COMP水平分别为2 210.59～3 143.87 ng/mL及＞3 143.87 ng/mL时，KOA患者K/L分级中重度进展的风险分别增加2.091倍和5.682倍(P＜0.001)。结论 KOA患者血清COMP水平普遍升高，且高血清COMP水平与疾病严重程度增加也有关。血清COMP有望成为临床诊断或疾病进展评估的潜在生物标志物。

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	刘昌海
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	张豪杰
	李蓉

关键词 ：软骨寡聚基质蛋白, 膝骨关节炎, Kellgren-Lawrence分级, Lequesne指数

Abstract：

Objective To analyze the relationship between serum cartilage oligomeric matrix protein (COMP) level and the occurrence and development of knee osteoarthritis (KOA).Methods 255 patients with bilateral KOA admitted to our hospital from April 2012 to March 2019 were selected as the KOA group，and 100 healthy volunteers who came to our hospital for physical examination during the same period were selected as the control group.There were 168 males and 87 females in KOA group.The patients aged from 28 to 85 years old，and the average age was (59.77±11.01) years old.There were 67 males and 33 females in the control group.The patients aged from 20 to 86 years，and the average age was (58.96±12.42) years old.The level of serum COMP was detected by enzyme-linked immunosorbent assay.The Kellgren-Lawrence (K/L) scale，the Western Ontario and McMaster Universities(WOMAC) osteoarthritis index and Lequesne index were used to assess KOA disease severity.Results The serum COMP level in KOA group was significantly higher than that in control group (P＜0.001).According to receiver operating characteristic analysis，the area under the curve of KOA at serum COMP level was 0.789.The probability of smoking history，duration of pain and the expression of typeⅢ procollagen amino terminal peptide (PⅢNP) in patients with serum COMP high-level group were higher than those in low serum COMP level group，and the Timed Up and Go test was lower than those in low serum COMP level group (P＜0.05).Spearman rank correlation analysis showed that serum COMP level was positively correlated with WOMAC，Lequesne index and K/L grade in KOA patients (r＝0.195，0.393，0.481，P＜0.05).Multivariate logistic regression analysis showed that when serum COMP levels were between 2 210.59 to 3 143.87 ng/mL or ＞3 143.87 ng/mL，the risk of moderate and severe progression of K/L grade in patients with KOA increased by 2.091 times and 5.682 times，respectively (P＜0.001).Conclusion Serum COMP level is generally increased in KOA patients，and high serum COMP level is also associated with increased disease severity，which is expected to be a potential biomarker for clinical diagnosis or assessment of disease progression.

Key words： cartilage oligomeric matrix protein knee osteoarthritis Kellgren-Lawrence classification Lequesne index

通讯作者: 李蓉

作者简介: 刘昌海(1981－ )，男，副主任医师，上海交通大学医学院附属新华医院崇明分院骨科，lachiz319333@163.com

引用本文:

刘昌海，王占朝，张豪杰，李蓉. 血清软骨寡聚基质蛋白水平与膝骨关节炎发生发展的关系研究[J]. 实用骨科杂志, 2023, 29(01): 22-.
Liu Changhai，Wang Zhanchao，Zhang Haojie，Li Rong. Study on The Relationship Between Serum Cartilage Oligomeric Matrix Protein and Knee Osteoarthritis. sygkzz, 2023, 29(01): 22-.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2023/V29/I01/22

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