Lesnyak O M, Zubareva E V, Goncharova M G, Maksimov D M
Ural State Medical University, Ministry of Health of Russia, Yekaterinburg, Russia; I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia.
City Clinical Hospital Forty, Yekaterinburg, Russia.
Ter Arkh. 2017;89(5):53-59. doi: 10.17116/terarkh201789553-59.
To establish a possible association between knee osteoarthritis (OA) and lower extremity venous diseases ((LEVDs) on the basis of thorough clinical and instrumental studies.
A case-control study recruiting 40-60-year-old women was conducted. A study group included 85 women with knee OA; a control group consisted of 50 women without this condition. The patients of both groups underwent assessment of complaints and goal-directed objective examination to identify joint diseases and chronic LEVDs, knee X-ray study, and duplex scanning of the lower extremity veins.
The patients with knee OA were more frequently diagnosed with lower extremity varicose vein disease (VVD) (43% vs 22%; p=0.015) and had signs of chronic venous insufficiency (28% vs 12%; p=0.03). Duplex scanning of the lower extremities showed that knee OA was characterized by generalized LEVD (bilateral valve lesions of the great and small saphenous veins and severe valvular incompetence in the veins) that was detected in 53% of the patients in this group versus 20% of the women in the control group (p = 0.0004). After adjustment for body mass index, the differences in the incidence of VVD between the groups remained clinically and statistically significant (odds ratio (OR), 2.7; 95% confidence interval, 1.1-6.7; p=0.036).
The 40-60-year-old patients with knee OA more commonly develop symptoms of chronic venous insufficiency than their healthy peers. Although obesity is a risk factor for both diseases, there is an independent association between knee OA and lower extremity VVD.
通过全面的临床和仪器研究，建立膝骨关节炎（OA）与下肢静脉疾病（LEVDs）之间可能存在的关联。
开展一项针对40 - 60岁女性的病例对照研究。研究组包括85名膝骨关节炎女性患者；对照组由50名无此病症的女性组成。两组患者均接受了症状评估以及针对性的客观检查，以确定关节疾病和慢性下肢静脉疾病，进行了膝部X线检查以及下肢静脉的双功扫描。
膝骨关节炎患者更常被诊断出患有下肢静脉曲张疾病（VVD）（43%对22%；p = 0.015），并且有慢性静脉功能不全的体征（28%对12%；p = 0.03）。下肢双功扫描显示，膝骨关节炎的特征是普遍存在下肢静脉疾病（大隐静脉和小隐静脉双侧瓣膜病变以及静脉严重瓣膜功能不全），该疾病在研究组53%的患者中被检测到，而对照组女性中这一比例为20%（p = 0.0004）。在对体重指数进行调整后，两组之间VVD发病率的差异在临床和统计学上仍然显著（优势比（OR）为2.7；95%置信区间为1.1 - 6.7；p = 0.036）。
40 - 60岁的膝骨关节炎患者比健康同龄人更常出现慢性静脉功能不全的症状。尽管肥胖是这两种疾病的风险因素，但膝骨关节炎与下肢VVD之间存在独立关联。
