Correlation of serum inflammatory factors and MRI features of knee osteoarthritis
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摘要:
目的 探讨血清炎症因子与膝骨关节炎（KOA）MRI影像学特征的相关性。 方法 选取2020年1月~2021年5月于我院收治的膝骨关节炎患者120例作为研究组，另选取同期健康体检人员90例作为对照组。根据是否有滑膜炎将研究组分为Ⅰ组（滑膜炎，n=71）和Ⅱ组（无滑膜炎，n=49）。比较所有患者MRI影像学表现和血清炎症因子[肿瘤坏死因子-α（TNF-α）、白细胞介素-1（IL-1）、白细胞介素-6（IL-6）和白细胞介素-1β（IL-1β）]水平，并对KOA患者MRI影像学特征与血清炎症因子相关性进行分析。 结果 Ⅰ组所有患者均存在软骨病变，且66.20%为2级软骨病变，而Ⅱ组患者有5例无软骨病变，病变患者59.18%为1级。Ⅰ组软骨厚度低于Ⅱ组（P < 0.05）。血清中IL-1β、IL-6和TNF-α表达水平对照组 < Ⅱ组 < Ⅰ组（P < 0.05），IL-10表达水平Ⅱ组 < Ⅰ组 < 对照组（P < 0.05）；Ⅰ组血清炎性细胞因子中IL-1β、IL-6和TNF-α与MRI软骨分级呈正相关关系（r=0.387、0.289、0.426，P < 0.05），IL-10无相关性（P > 0.05）；Ⅱ组血清炎性细胞因子中仅IL-1β与MRI软骨分级呈正相关关系（r=0.509，P < 0.05），IL-6、IL-10和TNF-α均无相关性（P > 0.05）；KOA合并滑膜炎患者MRI滑膜厚度与血清炎性细胞因子中IL-1β、IL-6和TNF-α呈正相关（r=0.497、0.425、0.506，P < 0.05）；MRI软骨厚度与血清炎性细胞因子中IL-1β和TNF-α呈负相关（r=-0.503、-0.313，P < 0.05）。 结论 KOA患者MRI可见明显异常，与血清炎性因子有一定的相关性，膝关节影像学特征与血清炎性因子水平结合可对KOA临床诊断及治疗提供指导价值。 Abstract:Objective To investigate the correlation between serum inflammatory factors and MRI features of knee osteoarthritis (KOA). Methods A total of 120 patients with knee osteoarthritis admitted to our hospital from January 2020 to May 2021 were selected as the research group, and another 90 healthy persons during the same period were selected as the control group. Patients in research group were divided into group Ⅰ (synovitis) and group Ⅱ (no synovitis) according to whether there was synovitis. MRI findings and serum levels of inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), interleukin-6 (IL-6) and interleukin-1β (IL-1β)] in all patients were compared. The correlation between MRI imaging features and serum inflammatory factors in KOA patients was analyzed. Results All patients in group Ⅰ had chondropathy, and 66.20% had grade 2 chondropathy, while 5 patients in group Ⅱ had no chondropathy, 59.18% had grade 1 chondropathy. The thickness of cartilage in group Ⅰ was lower than that in group Ⅱ (P < 0.05). The expression levels of IL-1β, IL-6 and TNF-α in serum were lower than those in control group < group Ⅱ < group Ⅰ (P < 0.05). The expression levels of IL-10 were lower than those in group Ⅱ < group Ⅰ < control group (P < 0.05). Il-1β, IL-6 and TNF-α were positively correlated with MRI cartilage grading in group Ⅰ (r= 0.387, 0.289, 0.426, P < 0.05), while IL-10 was not correlated with MRI cartilage grading (P > 0.05). Only IL-1β was positively correlated with MRI cartilage grading in group Ⅱ (r=0.509, P < 0.05), while IL-6, IL-10 and TNF-α were not correlated (P > 0.05). MRI synovial thickness was positively correlated with IL-1β, IL-6 and TNF-α in serum inflammatory cytokines in patients with KOA combined with synovitis (r=0.497, 0.425, 0.506, P < 0.05). The thickness of MRI cartilage was negatively correlated with il-1β and TNF-α in serum inflammatory cytokines (r=-0.503, -0.313, P < 0.05). Conclusion MRI abnormalities in patients with KOA are significantly correlated with serum inflammatory factors. The combination of knee imaging features and serum inflammatory factors can provide guidance for the clinical diagnosis and treatment of KOA. -
图 1 右膝内外侧半月板MRI平扫
A、D、G：右膝内外侧半月板矢状面平扫图像; B、E、H：右膝内外侧半月板冠状面平扫图像; C、F、I：右膝内外侧横断面平扫图像.
Figure 1. MRI plain scan of medial and lateral meniscus of right knee.
图 2 右膝前后韧带MRI平扫
A、D、G：右膝前后韧带矢状面平扫图像; B、E、H：右膝前后韧带冠状面平扫图像; C、F、I：右膝前后韧带横断面平扫图像.
Figure 2. MRI plain scan of anterior and posterior ligaments of the right knee.
表 1 两组一般资料比较
Table 1. Comparison of general data of two groups
组別 性別(n) 年龄(岁） 膝关节综合评分(分, Mean±SD) 男 女 最小 最大 Mean±SD 对照组(n=90) 40 50 41 73 59.49±6.31 8.19±0.89 研究组(n=120) 55 65 48 75 60.97±6.78 8.07±0.85 χ2/t 0.159 1.612 0.992 P 0.687 0.108 0.322 
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表 2 KOA患者膝关节MRI检查结果对比
Table 2. Comparison of MRI results of knee joint in patients with KOA
组別 软骨病变程度[n(%)] 软骨厚度(mm, Mean±SD） 0级 1级 2级 3级 4级 Ⅰ组(n=71) 0(0.00) 2(2.82) 47(66.20) 15(21.13) 7(9.86) 0.44±0.06 Ⅱ组(n=49) 5(10.20) 29(59.18) 8(16.33) 4(8.16) 3(6.12) 0.98±0.11 χ2/t 62.219 34.610 P < 0.001 < 0.001 Ⅰ组：滑膜炎; Ⅱ组：无滑膜炎.
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表 3 三组血清炎性因子水平对比
Table 3. Comparison of serum inflammatory factors in three groups(pg/mL, Mean±SD)
组别 IL-1β IL-6 IL-10 TNF-α 对照组(n=90) 43.66±4.54 85.69±8.70 7.56±0.83 21.49±2.36 Ⅰ组(n=71) 116.36±12.01 146.07±15.85 7.08±0.74 53.66±5.45 Ⅱ组(n=49) 56.08±6.01 98.84±10.12 6.41±0.70 28.57±3.04 F 1698.575 536.373 35.479 1473.475 P < 0.001 < 0.001 < 0.001 < 0.001
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表 4 KOA患者MRI软骨分级与血清炎性细胞因子相关性
Table 4. Correlation between MRI cartilage grading and serum inflammatory cytokines in patients with KOA
指标 Ⅰ组 Ⅱ组 r P r P IL-1β 0.387 < 0.001 0.509 < 0.001 IL-6 0.289 < 0.001 0.150 0.125 IL-10 0.108 0.756 0.114 0.347 TNF-α 0.426 < 0.001 0.193 0.346
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表 5 KOA合并滑膜炎患者MRI软骨厚度、滑膜厚度与血清炎性细胞因子相关性
Table 5. Correlation between MRI cartilage thickness, synovial thickness and serum inflammatory cytokines in patients with KOA complicated with synovitis
指标 滑膜厚度 软骨厚度 r P r P IL-1β 0.497 < 0.001 -0.503 < 0.001 IL-6 0.425 < 0.001 0.057 0.521 IL-10 0.138 0.165 0.078 0.742 TNF-α 0.506 < 0.001 -0.313 0.006
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