标题：膝骨关节炎关节液和滑膜中IL-18与MMP-13的表达及临床意义

      作者：朱振标，张 寿，刘亦恒，金旭红，林之斌
    (海口市人民医院骨科中心，海南 海口 570208)

      卷次： 2015年26卷15期

      【摘要】 目的 探讨膝骨关节炎(KOA)患者的关节液和滑膜中白细胞介素(IL)-18与基质金属蛋白酶
(MMP)-13的表达及其临床意义。方法 选取2011年1月至2013年12月期间我院收治的76例KOA患者作为观
察组，76例患者中，轻度30例，中度26例，重度20例。所有受试者软骨损伤分度为Ⅱ度26例，Ⅲ度28例，Ⅳ度22
例；另选择 32例膝关节半月板损伤患者为对照组。检测受试者膝关节关节液、滑膜中 IL-18、MMP-13表达情
况。结果 观察组患者的膝关节关节液和膝关节滑膜中的 IL-18、MMP-13水平均高于对照组，差异均有显著统
计学意义(P<0.01)；随着KOA程度的加重，关节液和滑膜中的 IL-18、MMP-13水平呈上升趋势，差异均有显著统
计学意义(P<0.01)；随着KOA分度的增加，关节液和滑膜中的 IL-18、MMP-13水平呈上升趋势，差异均有显著统
计学意义(P<0.01)；关节液 IL-18、MMP-13水平与滑膜 IL-18、MMP-13水平分别呈正相关(r=0.361，0.371，P=
0.021，0.016)；关节液 IL-18水平与关节液MMP-13水平呈正相关(r=0.369，P=0.019)；滑膜 IL-18水平与滑膜
MMP-13水平呈正相关(r=0.378，P=0.015)；关节液和滑膜中 IL-18、MMP-13水平与KOA程度、KOA分度均呈正
相关(P<0.05)。结论 MMP-13、IL-18在KOA关节液和滑膜中均高表达；两者呈现出显著正相关，共同在KOA
的发病及病情进展中起作用。

      【关键词】 骨性关节炎；白细胞介素；基质金属蛋白酶；关节液；滑膜

      【中图分类号】 R684.3 【文献标识码】 A 【文章编号】 1003—6350（2015）15—2227—04


Expression and clinical significance of IL-18 and MMP-13 in synovial and joint fluid in knee osteoarthritis.
ZHU Zhen-biao, ZHANG Shou, LIU Yi-heng, JIN Xu-hong, LIN Zhi-bin.
Department of Orthopaedics, Haikou People's
Hospital, Haikou 570208, Hainan, CHINA

【Abstract】 Objective To study expression and clinical significance of IL-18 and MMP-13 in synovial and
joint fluid in knee osteoarthritis (KOA). Methods From January 2011 to December 2011, 76 patients of KOA admitted in
our hospital were selected as observation group, including 30 mild cases, 26 moderate cases and 20 severe cases. Accord-
ing to the cartilage damage degree, the patients were divided into 26 cases ofⅡ degree, 28 cases ofⅢ degree, and 22 cas-
es ofⅣ degree. Thirty-two patients of knee joint meniscus injury were selected as the control group. The expression levels
of IL-18, MMP-13 in synovial and joint fluid in knee joint of patients were tested. Results The levels of IL-18,
MMP-13 in synovial and joint fluid in knee joint were significantly higher in the observation group than the control group
(P<0.01). As the degree of the KOA was aggravating, IL-18, MMP-13 levels in synovial and joint fluid were on the rise,
and there was statistically significant difference (P<0.01). With the increase of KOA dividing, IL-18, MMP-13 levels in sy-
novial and joint fluid were on the rise, and there was statistically significant difference (P<0.01). The levels of IL-18,
MMP-13 in joint fluid were positively correlated with those in synovial fluid (r=0.361, 0.371, P=0.021, 0.016). IL-18 level
of joint fluid had positive correlation with MMP-13 level of joint fluid (r=0.369, P=0.019), and synovial IL-18 and synovi-
al MMP-13 levels were positively related (r=0.378, P=0.378). In joint fluid, synovial IL-18, MMP-13 levels showed a
positive correlation with the degree of the KOA, KOA dividing (P<0.05). Conclusion MMP-13, IL-18 are highly ex-
pressed in the synovial and joint fluid of KOA, and there is a significant positive correlation between the two, which
play a role in the pathogenesis of KOA.