The Expression Of Inflammatory Cytokines In Serum And Synovial Fluid In Patients With Knee Osteoarthritis And Its Significance

Osteoarthritis affects the knees,hip,spine and hands primarily,is a common degenerative joint disease in the worldwide..It often causes pain and dysfunction of the joint,even leads to patients with depression and anxiety symptoms, reduces the patients quality of life seriously,at the same time,the high price of TKA,it increases the economic burden of the patients. Currently,there is no cure in clinical treatment of osteoarthritis completely,in the early stage of osteoarthritis, the destination is to relieve the pain and improve joint function, but in the late stage, it often need joint replacement.There are many classification ways of osteoarthritis, it is divided to radio-graphic and symptomatic osteoarthritis,according to the imaging and symptoms.During the process of diagnosis,it appears the misdiagnosis or missed diagnosis because of the pain Magnification by patients.One study showed that the prevalence of radio-graphic KOA(42.8%) and symptomatic KOA (15.0%) in the elderly female over 60 years in our country was higher than in the elderly American female,in contrast there was no difference in male.At present, the clinical diagnosis of knee osteoarthritis is also through imaging and symptoms,there is no consistent standard diagnosis of OA by different imaging examination,and the results of X-ray and MRI are often different from the results of arthroscopic examination.the damage of cartilage can be observed directly by arthroscope, but it is a invasive examination, and can not be used as a routine diagnosis of KOA.The pathological characteristics of OA is the cartilage destruction,bone hyperplas,osteohyte formation and aseptic inflammation.the imaging diagnosis of OA by the change of bone,but it can not find the slight changed structure of cartilage.To data,many researches show that in the development and progression of OA,the change of the articular cartilage is clear,and many inflammatory cytekines (leukocyte interleukin-6、8 and vascular endothelial growth factor)involve into the cartilage metabolism and damage it.In summary,the topic is that according to the diagnosis of KOA by imaging and arthroscopy,the related inflammatory detection of serum and joint fluid of KOA patients,provides the biochemical indexes for the diagnosis of KOA in different stages.to early diagnosis,intervention and treatment,improve the quality of patients’ life.The topic consists of 2 sections:Section 1:Clinical Research and Analysis of Imaging and Arthroscopy in the Diagnosis of Knee Osteoarthritis.Section 2:Expression and Significance of Inflammatory Cytokines in Serum and Synovial Fluid of Patients with Knee Osteoarthritis.Section 1:Clinical Research and Analysis of Imaging and Arthroscopy in the Diagnosis of Knee OsteoarthritisObjective:Through the imaging and arthroscopy for the diagnosis and classification of patients with knee osteoarthritis,to discuss the significance of X-ray,MRI and arthroscopy in the diagnosis of KOA.Method:230 cases due to knee osteoarthritis for knee arthroscopy or joint replacement surgery in the Central Hospital of Jingzhou from 2014 to 2016 had been selected.All has MRI and X-ray examination pre-operation, and assessment and classification of cartilage damage,again it after arthroscopy,to analysis the data of pre-and post-operation.Result:X-ray has advantage in showing bone hyperplasia，joint space narrowing and ligament calcification; MRI is better than X-ray in displaying the changes of articular cartilage and subchondral bone,meniscus,synovial hyperplasia,joint effusion. Arthros-copy can diagnosis the articular injury more accuracy.Conclusion:Currently, MRI and X-ray are commonly used in clinical diagnosis of knee osteoarthritis, in the different stages of the development of the knee osteoarthritis, two inspection methods have their own advantages, especially for early clinical diagnosis. MRI is better.Imaging in diagnosis of early osteoarthritis is still inadequate, often need to arthroscopy clear-cut.Section 2:Expression and Significance of Inflammatory Cytokines in Serum and Synovial Fluid of Patients with Knee Osteoarthritis.Objective:On the basis of the diagnosis and classification of KOA by imaging and arthroscopy (or joint replacement),to analysis the expression and significance of inflammatory cytokines in serum and synovial fluid of patients with KOA.Methods:48 cases KOA patients for arthroscopy or joint replacement in our hospital was selected from 2014 Sept to 2015 Sept.Dividing them to different group by KOA clinical stage and OA grade,18cases in the early stage,16 in the middle and 12 in the late stage,collecting their serum and synovial fluid to test the content of IL-6,IL-8 and VEGF(experiment group).Choose 48 cases healthy volunteers from the outpatient medical center to detect the content of IL-6, IL-8 and VEGF in serum and synovial fluid (control group).Results:Compared with the control group, experimental group has a higher concentration of IL-6，IL-8 and VEGF(P<0.05); acoording to the clinical grade and stage, IL-6, IL-8 and VEGF gradually increase with the devolpment of KOA (P< 0.05); although IL-8 has little change in metaphase and advanced stage,compared to the early stage,it still increases(P<0.05).Conclusion：the inflammatory cells have participated in the formation and development of osteoarthritis, in the KOA aseptic inflammation process, IL-6, VEGF can be used as an effective index to assess the severity of KOA and IL-8 may be one index on acute stage of KOA.