来源：风湿病与关节炎,2023,12（3）:24-28.

关节滑液中白细胞介素-18水平与膝骨关节炎病情的相关性分析（临床研究）

陈景涛，陈　有，李玉静，刘志刚

　　【摘　要】目的：探讨关节滑液中白细胞介素-18（IL-18）水平与膝骨关节炎严重程度的相关性。方法：选取2021年2月至2022年11月在河南大学第一附属医院就诊的98例膝骨关节炎患者为研究组，选取同期无关节炎影像学表现的膝关节运动型损伤患者52例为对照组。按照X线Kellgren-Lawrence（K-L）分级将研究组患者分为轻度、中度和重度膝骨关节炎组；采用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分评价膝骨关节炎症状严重程度；酶联免疫吸附法（ELISA）检测患者关节滑液中IL-18水平，分析IL-18水平与病情严重程度及症状评分的相关性。结果：轻度、中度和重度膝骨关节炎组的关节滑液IL-18水平均显著高于对照组（P < 0.05），且随着膝骨关节炎病情程度的加重，IL-18水平、疼痛评分、僵硬评分、肢体功能评分，以及WOMAC总分逐渐升高（P < 0.05）；IL-18与疼痛评分、僵硬评分、肢体功能评分，及WOMAC总分均呈正相关性（P < 0.05）；ROC曲线分析显示，关节滑液IL-18水平诊断膝骨关节炎病情严重程度的曲线下面积为0.771，敏感性为90.28%，特异性为65.38%。结论：关节滑液中IL-18水平与膝骨关节炎病情严重程度密切相关，对膝骨关节炎诊断具有一定的价值。

　　【关键词】　膝骨关节炎；白细胞介素-18；关节滑液；病情；相关性

Analysis of the Correlation Between the Level of IL-18 in Synovial Fluid and the Condition of Knee Osteoarthritis

CHEN Jing-tao,CHEN You,LI Yu-jing,LIU Zhi-gang

　　【ABSTRACT】Objective:To explore the correlation between the level of interleukin-18（IL-18）in synovial fluid and the severity of knee osteoarthritis.Methods:Ninety-eight patients with knee osteoarthritis who were treated in the First Affiliated Hospital of Henan University from February 2021 to November 2022 were selected as the study subjects,and 52 patients with knee joint motion injury who had no imaging manifestations of arthritis in the same period were selected as the control group.According to the X-ray Kellgren-Lawrence（K-L）classification,the patients were divided into the mild,moderate and severe knee osteoarthritis groups.The severity of symptoms of knee osteoarthritis was evaluated by the WOMAC score.The level of IL-18 in the synovial fluid of the patients was detected by ELISA,and the correlation between the level of IL-18 and the severity of the disease and the score of symptoms was analyzed.Results:The level of IL-18 in synovial fluid of the mild,moderate and severe knee osteoarthritis groups was significantly higher than that of the control group（P < 0.05）,and with the aggravation of knee osteoarthritis,the level of IL-18,pain score,stiffness score,limb function score and total WOMAC score were gradually increased（P < 0.05）.IL-18 was positively correlated with pain score,stiffness score,limb function score and total WOMAC score（P < 0.05）.ROC curve analysis showed that the area under the curve of IL-18 in synovial fluid for diagnosing the severity of knee osteoarthritis was 0.771,the sensitivity was 90.28%,and the specificity was 65.38%.Conclusion:The level of IL-18 in joint synovial fluid is closely related to the severity of knee osteoarthritis,and has certain value in the diagnosis of knee osteoarthritis.

　　【Keywords】 knee osteoarthritis;IL-18;joint synovial fluid;disease;relevance