Carp Stephen J, Barbe Mary F, Winter Kathryn A, Amin Mamta, Barr Ann E
Department of Physical Medicine, Chestnut Hill Health System, 8835 Germantown Avenue, Philadelphia, PA 19118, U.S.A.
Clin Sci (Lond). 2007 Mar;112(5):305-14. doi: 10.1042/CS20060050.
MSDs (musculoskeletal disorders) from overuse are common occupational health problems that cause pain, functional loss and loss of work time. The aim of the present study was to determine whether a relationship exists between the severity of early-onset overuse-related MSDs of the upper extremity and serum levels of IL-1beta (interleukin-1beta), TNF-alpha (tumour necrosis factor-alpha), IL-6 (interleukin-6) and CRP (C-reactive protein). Twenty-two subjects with upper-extremity MSDs due to overuse for no longer that 12 weeks were stratified according to the severity of upper-extremity signs and symptoms as determined by a UBMA (upper-body musculoskeletal assessment). Nine asymptomatic subjects also participated. Serum cytokines were analysed using ELISA, and CRP was analysed using a laser nephelometry technique. CRP was strongly correlated, and TNF-alpha, IL-1beta and IL-6 were moderately correlated, with UBMA scores. Only CRP and TNFalpha were significantly associated with UBMA scores in an ordinal logistic regression analysis in which age and BMI (body mass index) were covariates. These results are of clinical importance as they suggest that early-onset overuse-related MSDs may have an inflammatory component. The possibility of using a combination of serum biomarkers to follow the progression of overuse-related MSDs or their response to therapeutic intervention may be of interest to clinical practitioners and should be the focus of future research.
过度使用导致的肌肉骨骼疾病（MSDs）是常见的职业健康问题，会引起疼痛、功能丧失和工作时间损失。本研究的目的是确定上肢早期过度使用相关MSDs的严重程度与白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和C反应蛋白（CRP）的血清水平之间是否存在关联。22名因过度使用导致上肢MSDs且病程不超过12周的受试者，根据上肢肌肉骨骼评估（UBMA）确定的上肢体征和症状严重程度进行分层。9名无症状受试者也参与了研究。使用酶联免疫吸附测定法（ELISA）分析血清细胞因子，使用激光散射比浊法技术分析CRP。CRP与UBMA评分呈强相关，TNF-α、IL-1β和IL-6与UBMA评分呈中度相关。在以年龄和体重指数（BMI）为协变量的有序逻辑回归分析中，只有CRP和TNF-α与UBMA评分显著相关。这些结果具有临床重要性，因为它们表明早期过度使用相关的MSDs可能具有炎症成分。临床医生可能会对使用血清生物标志物组合来跟踪过度使用相关MSDs的进展或其对治疗干预的反应感兴趣，这应该是未来研究的重点。
