血清CTX—II、COMP在关节镜清理术治疗膝骨关节炎前后变化及临床意义【摘要】目的：探讨关节镜清理术治疗膝骨关节炎(kneeosteoarthritis,K0A)对血清CTX-II>COMP的影响,对比术前术后血清CTX-II、COMP含量以了解患者术后膝关节软骨修复情况。方法：选取2013年1月-2015年6月本院行关节镜清理术的膝骨关节炎患者60例，根据ICRS分级方法按病情分为I级组18例、II级组23例、III级组11例、IV级组8例。用ELTSA法测定患者术前及术后1周、1个月、3个月血清CTX-II和COMP含量，采用W0MAC评分评价患者术前术后膝关节功能。结果：不同分级患者关节镜清理术后1周、1个月、3个月WOMAC评分均较术前显著降低，差异均有统计学意义(P0.05)o各组患者血清CTX-II、COMP含量于术后1个月、3个月较术前均显著降低，差异均有统计学意义(P<0.05)o软骨损伤程度IV级患者术后1个月、3个月的W0MAC总评分、血清CTX-II、COMP含量均显著高于其他分级组，差异均有统计学意义(P<0.05)o结论：膝骨关节炎患者的血清CTX-II、COMP可作为关节镜清理术后膝关节软骨修复的评价指标，有助丁•对膝骨关节炎患者治疗预示进行评估。【关键词】II型胶原竣基端端肽；骨寡聚基质蛋白；软骨修复；膝骨关节炎；关节镜清理术TheVariationandClinicalSignificanceofSerumCTX-IIandCOMPinKneeOsteoarthritisPatienlsbeforeandafterTreatmentwithArthroscopicDebridement/ZOUXin-ming,ZHANWei-bing,FANNai-ren.//---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---MedicalInnovationofChina,2016,13(09)：013-017LAbstract】Objective：TostudytheinfluenceonserumCTX-IIandCOMPofarthroscopicdebridementinthetreatmentofkneeosteoarthritispatients,andtoevaluatethejointcartilagerepairingprogressviacomparingthelevelofserumCTX-IIandCOM卩beforeandafteroperation.Method:Sixtypatientswithkneeosteoarthritiswhounderwenta/rthroscopicdebridementinourhospitalfromJanuary2013toJune2015wereselected,theyweredividedintothefourgroupsaccordingtotheICRSgrade,whichincludes18patientsinthegradeTgroup,23patientsinthegradeIIgroup,11patentsinthegradeIIIgroupand8patientsinthegradeIVgroup.TheserumCTX-IIandCOM卩ofallpatientsweredetectedbyELISAbeforearthroscopicdebridementoperationandat1week,1monthand3monthsaftertheoperation.卩atientskneefunctionswereevaluatedbymeasurementsofWOMACscoreatthesametime.ResuIt：TheWOMACscoresofpatientsindifferentgroupsal1decreasedat1week,1monthand3monthsaftertheoperaticmthanbeforeoperation,thedifferenceswerestatisticallysignificant(P0.05)paredwithbeforeoperation,theserumCTX-IIandCOMPofallfourgroupsweresignificantlydecreasedat1monthand3monthsaftertheoperation,thedifferenceswerestatisticallysignificant(卩【Keywords］CTX-II；COMP；Cartilagerepairing；Kneeosteoarthritis；ArthroscopicdebridementFirst-author*saddress:---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---YangchunHospitalofTraditionalChineseMedicine,Yangchun529600,Chinadoi：10.3969/j.issn.1674-4985.2016.09.004膝关节骨性关节炎是中老年人的常见病和多发病，软骨进行性破坏是其主要病理特征。在所研究的生物标志物中，II型胶原竣基端端肽(C-terininalcrosslinkingtelopeptideoftypeIIcollagen,CTX-II)是近年来研究热点，可反映膝关节软骨损伤，对关节软骨损伤程度评估具有特异性［1］。另一类非胶原蛋白，骨寡聚基质蛋白(Cartilageoligomericmatrixprotein,COMP),可结合II型胶原纤维，稳定关节软骨的胶原-纤维网络，是关节软骨细胞外基质的一种大分子［2］,与膝关节炎严重程度相关。关节镜清理术可改善早、中期膝骨关节炎患者症状，延缓关节软骨退变［3］。但清理术示对于关节软骨修复情况的评估研究较少,本研究通过检测患者膝关节镜清理术术前、术后不同时段血清CTX-II、COMP含量及关节功能评分，尝试从生物标志...