[滑液和软骨中微量元素与膝关节骨关节炎严重程度的关系]
[Relationship between trace elements in synovial fluid and cartilage and severity of knee osteoarthritis].
作者信息
Li Yongshi, Chen Hong, Mou Ping, Sun Bangjie, Zeng Yi, Yang Jing
机构信息
Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 May 15;37(5):584-588. doi: 10.7507/1002-1892.202302008.
OBJECTIVE
To investigate the relationship between trace elements in synovial fluid and cartilage and severity of knee osteoarthritis (KOA).
METHODS
Patients with KOA who underwent knee arthrocentesis or total knee arthroplasty (TKA) were recruited based on inclusion criteria between June 2021 and December 2021. Synovial fluid samples were obtained during knee arthrocentesis and TKA, and participants were divided into the mild group (grading Ⅰ/Ⅱ) and the severe group (grading Ⅲ/Ⅳ) according to the Kellgren-Lawrence grading (K-L grading). Cartilage samples with different degrees of wear were collected during the TKA from the same patient and were divided into mild wear (0-1 point) and severe wear (2-4 points) groups based on the Pelletier score. The contents of copper (Cu), zinc (Zn), and manganese (Mn) in synovial fluid and cartilage were evaluated by inductively coupled plasma mass spectrometry, and the differences between groups were compared.
RESULTS
A total of 33 synovial fluid samples were collected, including 19 specimens from 14 patients who underwent knee arthrocentesis of mild group, with 5 bilateral sides knee arthrocentesis in them, and 14 specimens from 14 TKA patients of severe group. The patients were significantly younger in the mild group than in the severe group ( <0.05), but there was no significant difference in gender or body mass index between the two groups ( >0.05). Nineteen pairs of cartilage samples with mild and severe wear were collected from severe KOA patients (K-L grading Ⅲ and Ⅳ), including 9 males and 10 females, with an average age of 70.4 years (range, 58-80 years). The body mass index ranged from 21.2 to 30.7 kg/m , with an average of 25.6 kg/m . The content of Zn in synovial fluid and cartilage from KOA patients was the highest, followed by Cu, and Mn was the lowest. The Cu content in synovial fluid was significantly higher in the severe group than in the mild group ( <0.05), and in the severe wear group than in the mild wear group ( <0.05). There was no significant difference in Zn and Mn content between the two groups ( >0.05).
CONCLUSION
The Cu content increases with the severity of cartilage wear in patients with KOA.
目的
探讨滑液和软骨中的微量元素与膝关节骨关节炎（KOA）严重程度之间的关系。
方法
根据纳入标准，招募2021年6月至2021年12月期间接受膝关节穿刺或全膝关节置换术（TKA）的KOA患者。在膝关节穿刺和TKA过程中获取滑液样本，并根据Kellgren-Lawrence分级（K-L分级）将参与者分为轻度组（Ⅰ/Ⅱ级）和重度组（Ⅲ/Ⅳ级）。在TKA期间，从同一患者收集不同磨损程度的软骨样本，并根据Pelletier评分将其分为轻度磨损（0-1分）和重度磨损（2-4分）组。采用电感耦合等离子体质谱法评估滑液和软骨中铜（Cu）、锌（Zn）和锰（Mn）的含量，并比较组间差异。
结果
共收集33份滑液样本，其中轻度组14例患者进行膝关节穿刺获取19份样本，其中5例为双侧膝关节穿刺，重度组14例TKA患者获取14份样本。轻度组患者年龄显著低于重度组（<0.05），但两组性别和体重指数无显著差异（>0.05）。从重度KOA患者（K-L分级Ⅲ和Ⅳ）中收集19对轻度和重度磨损的软骨样本，其中男性9例，女性10例，平均年龄70.4岁（范围58-80岁）。体重指数范围为21.2至30.7kg/m，平均为25.6kg/m。KOA患者滑液和软骨中Zn含量最高，其次是Cu，Mn含量最低。重度组滑液中Cu含量显著高于轻度组（<0.05），重度磨损组高于轻度磨损组（<0.05）。两组间Zn和Mn含量无显著差异（>0.05）。
结论
KOA患者软骨磨损严重程度增加时，Cu含量升高。
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