Study On The Correlation Between The Expression Of Tumor Necrosis Factor-α And Interleukin-6 In Joint Synovium And Knee Osteoarthritis With Bone Marrow Edema

Objective:By analyzing the correlation between the expression of tumor necrosis factor-α（Tumor necrosis factor,TNF-α）and interleukin-6（Interleukin-6,IL-6）in synovium and the degree of bone marrow edema（Bone marrow edema,BME）and（Knee Osteoarthritis,KOA）of knee osteoarthritis,to explore the role of BME in the formation and development of KOA and the role and influence of TNF-αand IL-6in the formation and evolution of BME and KOA.Methods:（1）A total of 60 patients treated in the Department of Orthopaedics,the Fifth Affiliated（Zhuhai）Hospital of Zunyi Medical University from March2019 to November 2020 were selected,including 30 patients with KOA with BME as the experimental group,and 30 patients with BME with knee joint pain who were examined by arthroscopy in the same period as the control group.（2）The degree of BME of knee joint in the experimental group and the control group was scored according to the whole organ magnetic resonance imaging score（Whole-organ magnetic resonance imaging score,WORMS）and the degree of BME was expressed by WORMS value.KSS（American knee society score,KSS）method was used to score knee joint function on admission,HE staining and immunohistochemical staining were used to detect the distribution and relative expression of TNF-αand IL-6 in synovial tissue of knee joint,and Westernblot method was used to detect the expression of TNF-αand IL-6 protein in synovial tissue of knee joint.（3）The sex and limb side factors of the two groups were tested byχ²test and the rank test was used in the course of disease;the WORMS value,KSS,age and the relative expression of TNF-αand IL-6 were tested by independent sample t test,and the relationship between WORMS value,KSS,TNF-αand IL-6 relative expression was analyzed by linear correlation analysis.（4）Multiple linear regression analysis was conducted to study the influencing factors of knee joint KSS by multiple linear regression analysis,was performed with KSS score as dependent variable Y,with WORMS value as independent variable X₁,relative expression of TNF-αas X₂and relative expression of IL-6 as X₃.Results:（1）There was no significant difference in sex,limb side,course of disease,age and other factors between the two groups（P>0.05）.（2）There was no statistical significance in the comparison of WORMS values between the two groups（P>0.05）.The KSS of the experimental group was significantly lower than that of the control group（P<0.05）.The relative expression of TNF-αand IL-6 in the synovium of the experimental group was higher than that of the control group,and there was statistical significance between the two groups（P<0.05）.（3）The linear correlation analysis of WORMS value,KSS,TNF-αand IL-6 relative expression in the experimental group showed that the WORMS value was correlated with the relative expression of TNF-αand IL-6 in the synovium,the correlation coefficient was 0.899 and 0.716 respectively,and it was negatively correlated with KSS,the correlation coefficient was-0.908.There was a strong correlation between KSS and the relative expression of TNF-αand IL-6 in synovium,and the correlation coefficients were-0.868 and-0.791 respectively.The relative expression of TNF-αwas positively correlated with the relative expression of IL-6,and the correlation coefficient was 0.620.（4）Multiple linear regression analysis was conducted with the WORMS value of knee joint KSS as independent variable X1,the relative expression of TNF-αas X2 and the relative expression of IL-6 as X3.The results showed that the WORMS value of knee joint KSS was negatively correlated with the expression of TNF-αand IL-6 in synovium（P<0.05）.The equation of multiple linear regression analysis was Y=157.374-0.637X₁-56.838X₂-139.463X₃.Conclusion:（1）The expression of TNF-αand IL-6 in synovium is related to the formation of BME in knee osteoarthritis with bone marrow edema.（2）The expression of TNF-α,IL-6 and the degree of BME in synovium are the main factors affecting the KSS of knee osteoarthritis with bone marrow edema.