Study on Relationship between Synovial Fluid Oxidative Stress Indexes and MMPs Indexes and Pain Degree and Foot-Ankle Function in Patients with Ankle Trauma
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.
Ankle traumaSynovial fluidMatrix metalloproteinasesFoot-ankle function
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