两种术式治疗膝骨性关节炎对IL-17和TGF-β的影响

Effects of two surgical methods on IL-17 and TGF-β in knee osteoarthritis

摘要:

［目的］探讨两种术式治疗膝骨关节炎的疗效及对白细胞介素 17（Interleukin 17, IL-17）、转化生长因子 β1（Trans- forming growth factor β1, TGF-β1） 的影响。［方法］ 2018 年 12 月—2019 年 12 月在本院接受治疗的膝骨关节炎患者共 127 例。 其中 63 例采用人工关节置换术治疗（关节置换组），64 例行腓骨近端截骨术治疗（截骨组）。比较两组围手术期、实验室检查结果。［结果］两组患者均顺利完成手术，术中无严重并发症。截骨组手术时间、术中出血量、住院时间及住院总费用均低于关节置换组 （P<0.05）。与术前相比，术后 1 个月两组 VAS、WOMAC 评分水平均显著降低 （P<0.05），HSS 评分均显著升高 （P<0.05）。术后 1 个月截骨组的上述评分均优于关节置换组 （P<0.05）。实验室检查，术后两组血清 IL-17 均较术前显著降低 （P<0.05），而 TGF-β1 水平较术前显著增加 （P<0.05），术后截骨组 IL-17 和 TGF-β1 水平均显著低于关节置换组 （P<0.05）。 ［结论］对膝骨关节炎患者中行腓骨近端截骨术效果显著，可有效改善患者 IL-17、TGF-β1 水平。

Abstract:

[Objective] To study effects of two surgical methods on interleukin 17 (IL-17) and transforming growth factor β1 (TGF-β1) in knee osteoarthritis. [Methods] A total of 127 patients received surgical treatment for knee osteoarthritis in our hospital from December 2018 to December 2019. Of them, 63 patients were treated with total knee arthroplasty (TKA) , while the remaining 64 patients underwent proximal fibular osteotomy (PFO) . The perioperative data, VAS, WOMAC and HSS scores, as well as serum level of IL-17 and TGF- β1 were compared between the two groups. [Results] All the patients in both groups had operation performed smoothly without serious intraop- erative complications. The PFO group proved significantly superior to the TKA group in terms of operation time, intraoperative blood loss, hospital stay and hospital expenses (P＜0.05) . Compared with those preoperatively, the VAS and WOMAC score significantly decreased (P＜ 0.05) , whereas the HSS score significantly increased at 1 month postoperatively (P＜0.05) . The PFO group proved significantly superior to the TKA group in abovesaid scores at 1 month postoperatively (P＜0.05) . Regarding to laboratory test, the Il-17 significantly decreased, while the TGF-β1 significantly increased postoperatively in both groups compared with those before operation (P＜0.05) . The PFO group had significantly lower IL-17 and TGF-β1 than the TKA group postoperatively (P＜0.05) . [Conclusion] The proximal fibular osteotomy has sound outcomes for knee osteoarthritis, and can effectively improve Il-17 and TGF-β1 levels.