KLF5和MMP9表达与膝关节软骨神经血管入关系的临床研究.docx

中文摘要 KLF5和MMP．9表达与膝关节软骨神经血管 侵入关系的临床研究 摘 要 目的：观察Kruppel样因子5(krtippel．1ike factor 5，KLF5)和基质 金属蛋白酶．9(matrix metalloproteinase．9，MMP．9)表达活性与骨关节炎 患者膝关节软骨血管及神经纤维侵入情况之间的关系。 方法与结果：于河北医科大学第三医院关节外科随机选取20例行全 膝关节置换术的患者，男性3例、女性1 7例，平均年龄67．2岁(55 ．74岁)，均为患者及家属知情同意。在术中截骨中获取胫骨平台(包括 软骨及软骨下骨)，区分磨损与相对无磨损区域；选取3 1个关节标本，将 每个标本切割成2．3块(边长大约为0．5cm)，并分成磨损组(SC，n=29) 和无磨损组(NC，n=17)。将所有标本置于10％的福尔马林溶液中浸泡保 存，以便进行各种染色。 番红O及HE染色可见，在磨损组的关节软骨潮线附近有血管化发生， 扫描电镜也证实血管结构的存在；关节软骨的神经侵袭仅发生于血管化的 标本；与无磨损的关节软骨区比较，磨损区的血管化和神经支配数量明显 增加(P0．05)。 免疫组化染色可见，在磨损组的关节软骨中， KLF．5、MMP．9的表 达活性明显高于无磨损组(PO．05)，而且，与血管侵袭程度具有正相关 关系。 结论：骨关节炎关节软骨的神经侵袭是发生于血管化后的继发病变。 病变区域增加的KLF．5和MMP．9表达可能是骨关节炎软骨退变和神经血 管化的重要机制之一。 关键词：KLF5；MMP．9；血管化；软骨退变；骨关节炎  英文摘要 The clinical study of the relationship of KLF5 and MMP·9 ● - l ● ● ■ ■ o o eXDresslon and neUr0VaSCUIar lnVaSlon ln osteOartnritls ABSTRACT objective：To investigate the relationship between the expression of factor of kriippel-like factor(KLF)·5，matrix metalloproteinase-9(MMP-9)and neurovascular invasion in osteophytes in osteoarthritis(OA)． Methods and results：3 1 articular cartilage samples were collected from 20 patients who had undergone total knee arthroplasty(TKA)，and each sample was divided into two groups，no change(NC，n=1 7)and severe change(sc， n-29)according to Mankin score and safranin O staining．Neurovascular markers protein gene product(PGP)9．5 and CD34，and the expression of KLF一5，MMP一9 were detected by immunohistochemistry． Vascular channels were observed in both NC and SC sections．In SC sections，1 6／29(5 5．2％)sections displayed vessels entering the calcified cartilage，which was more than that in NC group(2／1 7，1 1．7％，P0．05)．The frequency of neurovascular invasion Was significantly different between SC and NC(PO．05)．Innervation always accompanied vascular invasion at the osteochondral junction．The severity of neurovascular invasion was positively correlated with the expression of KLF5 and MMP一9 in chondrocytes at the same site that was significantly different between SC and