| 摘要: |
| 目的 研究患者膝关节液中4种炎性因子（IL-1β、IL-6、IL-8、TNF-α）的表达水平及其与相应组织病理学的关系。方法 在关节外科手术前，抽取31例患者的膝关节液，采用流式细胞小球微阵列术方法检测膝关节液中IL-1β、IL-6、IL-8、TNF-α表达水平，同时分析其滑膜组织病理学特征。所有患者按照组织病理学诊断分为骨关节炎（OA）、假体置换后翻修（RPR）、色素性绒毛结节性滑膜炎（PVNS）和类风湿关节炎（RA），另根据滑膜组织内含铁血黄素情况分为含铁血黄素沉着组和非含铁血黄素沉着组，根据滑膜组织内炎细胞浸润情况分为炎细胞浸润组和非炎细胞浸润组，按照膝关节液颜色分为血性膝关节液组和非血性膝关节液组。结果 31例患者中男9例、女22例，平均年龄（63.60±9.19）岁，左膝12例、右膝19例，OA 18例，RPR 5例，PVNS 5例，RA 3例。OA组患者膝关节液中4种炎性因子含量均最低，与其他3组比较差异均有统计学意义（P均<0.05）；RA组膝关节液中IL-1β水平高于RPR组和PVNS组，差异均有统计学意义（P均<0.05），但后两组间差异无统计学意义（P>0.05）；RA组膝关节液中IL-6水平高于PVNS组，但低于RPR组，3组间差异均有统计学意义（P均<0.05）；RA组膝关节液中IL-8水平高于RPR组和PVNS组，3组间差异均有统计学意义（P均<0.05）；RA组膝关节液中TNF-α水平高于RPR组和PVNS组，3组间差异均有统计学意义（P均<0.05）。炎细胞浸润组（11例）膝关节液中4种炎性因子水平均高于非炎细胞浸润组（20例），差异均有统计学意义（P均<0.05）。含铁血黄素沉着组（7例）膝关节液中4种炎性因子水平均高于非含铁血黄素沉着组（24例），差异均有统计学意义（P均<0.05）。血性膝关节液组（4例）与非血性膝关节液组（27例）相比，IL-1β差异有统计学意义（P<0.05），但IL-6、IL-8及TNF-α差异均无统计学意义（P均>0.05）。结论 IL-1β、IL-6、IL-8及TNF-α在多种关节疾病中有表达，且与其病理学特征等有相关性。这一发现有助于进一步研究某些关节疾病的发病和发展，可为临床诊断、治疗和基础研究提供参考。 |
| 关键词: 关节液 炎症因子 骨关节炎 色素性绒毛结节性滑膜炎 假体植入 类风湿关节炎 |
| DOI：10.16781/j.0258-879x.2020.09.1046 |
| 投稿时间：2019-10-30修订日期：2020-02-26 |
| 基金项目:上海市卫生和计划生育委员会面上项目（201540258）． |
|
| Correlation between expression of interleukin-1β, interleukin-6, interleukin-8 and tumor necrosis factor α in knee joint fluid and histopathology |
| MA Xiao-mei1*,FU Pei-liang2,ZHU Wei-jian1 |
(1. Department of Pathology, Changzheng Hospital, Naval Medical University(Second Military Medical University), Shanghai 200003, China;
2. Department of Orthopaedics, Changzheng Hospital, Naval Medical University(Second Military Medical University), Shanghai 200003, China
*Corresponding author) |
| Abstract: |
| Objective To study the correlation between the expression levels of four inflammatory factors (interleukin[IL]-1β, IL-6, IL-8 and tumor necrosis factor α[TNF-α]) in knee joint fluid and the related histopathology. Methods Before the joint surgery, the knee joint fluid was extracted from 31 patients. The expression levels of IL-1β, IL-6, IL-8 and TNF-α in knee joint fluid were examined by cytometric bead array, and the pathological feature of synovial tissues was analyzed. According to the histopathological diagnosis, the patients were divided into osteoarthritis (OA), revision after prosthesis replacement (RPR), pigmented villonodular synovitis (PVNS) and rheumatoid arthritis (RA) groups. According to the content of hemosiderin in the synovial tissue, they were divided into hemosiderin deposition group and non-hemosiderin deposition group. According to the infiltration of inflammatory cells in synovial tissue, they were divided into inflammatory cell infiltration group and non-inflammatory cell infiltration group. According to the color of knee joint fluid, they were divided into blood joint fluid group and non-blood joint fluid group. Results There were nine male and 22 female patients with an average age of (63.60±9.19) years, including 12 left knees and 19 right knees. There were 18 cases with OA, five with RPR, five with PVNS and three with RA. The levels of four inflammatory factors in the knee joint fluid of OA group were the lowest, which were significantly different from the other three groups (all P<0.05). The level of IL-1β in knee joint fluid of RA group was significantly higher than those of RPR group and PVNS group (both P<0.05), but there was no significant difference between the latter two groups (P>0.05). The level of IL-6 in knee joint fluid of RA group was significantly higher than that of PVNS group, but significantly lower than that of RPR group, and the differences between the three groups were significant (all P<0.05). The level of IL-8 in knee joint fluid of RA group was significantly higher than those of RPR group and PVNS group, and the difference between the three groups was significant (all P<0.05). The level of TNF-α in knee joint fluid of RA group was significantly higher than those of RPR group and PVNS group, and there were significant differences between the three groups (all P<0.05). The levels of four inflammatory factors in knee joint fluid of inflammatory cell infiltration group (11 cases) were significantly higher than those of non-inflammatory cell infiltration group (20 cases) (all P<0.05). The levels of four inflammatory factors in knee joint fluid in hemosiderin deposition group (seven cases) were significantly higher than those in non-hemosiderin deposition group (24 cases) (all P<0.05). There was significant difference in IL-1β between blood joint fluid group (four cases) and non-blood joint fluid group (27 cases) (P<0.05), but no significant differences found in IL-6, IL-8 and TNF-α (all P>0.05). Conclusion IL-1β, IL-6, IL-8 and TNF-α are expressed in various joint diseases and the expressions are related to their pathological features, which can help further understand the pathogenesis and development of some joint diseases, so as to provide a reference for clinical diagnosis, treatment and basic research. |
| Key words: joint fluid inflammatory factor osteoarthritis pigmented villonodular synovitis prosthesis implantation rheumatoid arthritis |
