河北医学2024，Vol.30Issue(9) ：1550-1554.DOI:10.3969/j.issn.1006-6233.2024.09.026

关节液氧化应激指标及MMPs指标与踝关节创伤患者疼痛程度及足踝功能的关系研究

Study on Relationship between Synovial Fluid Oxidative Stress Indexes and MMPs Indexes and Pain Degree and Foot-Ankle Function in Patients with Ankle Trauma

董建彬 白顺宁 陈强
河北医学2024，Vol.30Issue(9) ：1550-1554.DOI:10.3969/j.issn.1006-6233.2024.09.026
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关节液氧化应激指标及MMPs指标与踝关节创伤患者疼痛程度及足踝功能的关系研究

Study on Relationship between Synovial Fluid Oxidative Stress Indexes and MMPs Indexes and Pain Degree and Foot-Ankle Function in Patients with Ankle Trauma

董建彬 1白顺宁 2陈强1
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作者信息

  • 1. 陕西省榆林市第一医院,陕西 榆林 719000
  • 2. 陕西省延安市人民医院骨科,陕西 延安 716000
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摘要

目的:观察踝关节创伤患者关节液中氧化应激指标及金属基质蛋白酶(MMPs)水平的变化,并分析其与疼痛程度和足踝功能的关联性.方法:纳入163 例2020 年2 月至2023 年 2 月收治的踝关节创伤患者,测定患者关节液中氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]和 MMP-3、MMP-13 水平,分析其水平与患者疼痛程度和足踝功能的关系.结果:不同疼痛程度患者关节液 SOD、MDA、MMP-3、MMP-13 水平比较,差异有统计学意义(P<0.05),其中无疼痛组SOD水平高于轻度、中度组,差异有统计学意义(P<0.05),而MDA、MMP-3、MMP-13 水平则明显低于轻度、中度组,差异有统计学意义(P<0.05),轻度组 SOD 水平高于中度组,差异有统计学意义(P<0.05),而 MDA、MMP-3、MMP-13 水平则明显低于中度组,差异有统计学意义(P<0.05).不同踝关节功能患者关节液 SOD、MDA、MMP-3、MMP-13 水平比较,差异有统计学意义(P<0.05),其中优组 SOD 水平高于良组、可组、差组,差异有统计学意义(P<0.05),而MDA、MMP-3、MMP-13 水平则明显低于良组、可组、差组,差异有统计学意义(P<0.05),良组SOD水平高于可组、差组,差异有统计学意义(P<0.05),而MDA、MMP-3、MMP-13 水平则明显低于可组、差组,差异有统计学意义(P<0.05),可组SOD水平高于差组,差异有统计学意义(P<0.05),而MDA、MMP-3、MMP-13 水平则明显低于差组,差异有统计学意义(P<0.05).Spearman相关性分析显示:SOD与踝关节疼痛程度成负相关,差异有统计学意义(r=-0.546,P<0.05),MDA、MMP-3、MMP-13 与踝关节疼痛程度成正相关,差异有统计学意义(r=0.559、0.595、0.517,P<0.05);SOD与踝关节功能成正相关,差异有统计学意义(r=0.495,P<0.05),MDA、MMP-3、MMP-13 与踝关节功能成负相关,差异有统计学意义(r=-0.571、-0.574、-0.532,P<0.05).ROC 曲线显示:SOD、MDA、MMP-3、MMP-13 四项指标联合评估踝关节功能优良率的AUC为0.955,明显高于各单项指标的AUC,差异有统计学意义(P<0.05),同时评估的敏感度和特异度分别为 0.835、0.944.结论:不同疼痛程度和足踝功能的踝关节创伤患者关节液中 SOD、MDA、MMP-3、MMP-13 水平存在差异,并有助于对足踝功能恢复情况进行有效评估.

Abstract

Objective:To observe the changes of oxidative stress indexes and matrix metalloproteinases(MMPs)levels in synovial fluid of patients with ankle trauma,and to analyze their association with pain de-gree and foot-ankle function.Methods:A total of 163 patients with ankle trauma admitted from February 2020 to February 2023 were enrolled.The levels of oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)],MMP-3 and MMP-13 in synovial fluid were measured,and the relationship be-tween their levels and pain degree and foot-ankle function was analyzed.Results:There were statistical differences in the levels of SOD,MDA,MMP-3 and MMP-13 in synovial fluid among patients with different pain degrees(P<0.05).The level of SOD in the pain-free group was higher than that in the mild group and the moderate group(P<0.05)while the levels of MDA,MMP-3 and MMP-13 were significantly lower than those in the mild and moderate groups(P<0.05).The level of SOD in the mild group was higher than that in the moderate group(P<0.05),while the levels of MDA,MMP-3 and MMP-13 were significantly lower than those in the moderate group(P<0.05).The levels of SOD,MDA,MMP-3 and MMP-13 in the synovial flu-id of patients with different ankle functions were statistically different(P<0.05).The level of SOD in the ex-cellent group was higher than that in the good group,the fair group and the poor group(P<0.05),while the levels of MDA,MMP-3 and MMP-13 were significantly lower than those in the good group,the fair group and the poor group(P<0.05).The level of SOD in the good group was higher(P<0.05),while the levels of MDA,MMP-3 and MMP-13 were significantly lower than those in the fair group and the poor group(P<0.05).The level of SOD in the fair group was higher than that in the poor group(P<0.05)while the levels of MDA,MMP-3 and MMP-13 were significantly lower(P<0.05).Spearman correlation analysis showed that SOD was negatively correlated with ankle pain degree(r=-0.546,P<0.05),and MDA,MMP-3 and MMP-13 were positively correlated with degree of ankle pain(r=0.559,0.595,0.517,P<0.05).SOD was pos-itively correlated with ankle function(r=0.495,P<0.05).MDA,MMP-3 and MMP-13 were negatively correlated with ankle function(r=-0.571,-0.574,-0.532,P<0.05).ROC curve revealed that the AUC of the combination of the four indexes of SOD,MDA,MMP-3 and MMP-13 in evaluating the excellent and good rate of ankle function was 0.955,which was significantly higher than the AUC of each single index(P<0.05),and the sensitivity and specificity were 0.835 and 0.944 respectively.Conclusion:There are differ-ences in the levels of SOD,MDA,MMP-3 and MMP-13 in the synovial fluid of ankle trauma patients with different pain degrees and ankle functions,and the above indexes are meaningful to effectively evaluate the re-covery of foot-ankle function.

关键词

踝关节创伤/关节液/金属基质蛋白酶/足踝功能

Key words

Ankle trauma/Synovial fluid/Matrix metalloproteinases/Foot-ankle function

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基金项目

陕西省自然科学基础研究计划项目(S2020-JC-YB-1284)

出版年

2024
河北医学
河北省医学会

河北医学

CSTPCD
影响因子：1.915
ISSN：1006-6233
参考文献量6
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