中文摘要：

目的探讨血清及关节液白细胞介素（IL）-1β，IL-6，肿瘤坏死因子（TNF）-a与伴有骨髓水肿的膝骨关节炎（KOA）的相关性。方法收集我院KOA患者331例，根据膝关节磁共振成像（MRI）分为骨髓水肿组（172例）和非骨髓水肿组（159例），分别收集其临床症状、骨关节指数（WOMAC）评分，并同期检测其血清和关节液中IL-1β，IL-6，TNF—a水平，采用单因素方差分析比较2组之间的差异，Spearman相关分析探讨其炎症指标水平与骨髓水肿发生程度及其临床指标的相关性。结果①KOA患者血清及关节液IL-18、IL-6，TNF-a表达水平均呈正相关（血清r=0．24，0．38；关节液r=0．20，0．29；P均〈0．05）；IL．6与TNF．d水平呈正相关（血清r=0-31，P〈0．05；关节液r=0．33，P〈0．05）。②KOA伴骨髓水肿组内，血清及关节液IL．6和TNF-a水平较KOA不伴骨髓水肿组高（血清F=8．139，7．172；关节液F=9．201，7．001，P均〈0．05）；③血清及关节液IL．6，TNF．仅水平与KOA伴发骨髓水肿容积积分（血清t=0．27，0．26；关节液L=0．29，0．32；P均〈0．05）和程度积分（血清r=0．29，0．27；关节液L=0．29，0-31；P均〈0．05）呈正相关；④血清及关节液IL-1β，IL．6，TNF-a在伴有滑膜炎组的KOA中明显升高（骨髓水肿组血清F=3．931，5．866，5．514；关节液F=4．211，5．202，5．972；P均〈0．05。非骨髓水肿组血清F=3．513，3．114，7．112；关节液F=3．722，3．965，8．891；JP均〈0．05）。结论IL-1β，IL-6，TNF-a在KOA伴有滑膜炎时明显升高，在KOA伴骨髓水肿时尤以IL-6，TNF-a升高明显。

英文摘要：

Objective To investigate the correlation of the serum and synovial fluid interleukin （IL）- 1β, IL-6, tumor necrosis factor （TNF）-a and bone marrow edema with osteoarthritis of the knee （KOA）. Methods The clinical data of 331 KOA patients were included and all patients had knee MRI. Bone marrow edema were detected in 172 cases and 159 cases had non-bone marrow edema. The clinical symptoms, WOMAC score, and the serum and synovial fluid IL-1β, IL-6, TNF-a levels were compared using One-way ANOVA analysis and Spearman＇s correlation analysis. Results （1） The serum and synovial fluid IL-1β, IL-6, TNF-a in osteoarthritis was positively correlated （serum r=0.24, 0.38, 0.31; synovial fluid r=0.20, 0.29, 0.33; all P〈0.05）;（2） The serum and synovial fluid IL-6 and TNF-of levels of osteoarthritis with bone marrow edema were significantly higher than those of the osteoarthritis without bone marrow edema （serum F=8.139, 7.172; synovial fluid F=9.201, 7.001; all P〈0.05）; （3） The serum and synovial fluid TNF-a, IL-6 levels was associated with osteoarthritis with bone marrow edema in volume （serum r=0.27, 0.26; synovial fluid r=0.29, 0.32; all P〈0.05） and severity （serum r=0.29, 0.27; synovial fluid rs=0.29, 0.31; all P〈0.05）; （4） The serum and synovial fluid IL-1β, IL-6, TNF-a of osteoarthritis with synovitis was significantly higher than that of osteoarthritis without synovitis group （group of bone edema： serum F=3.931, 5.866, 5.514; synovial fluid F=4.211, 5.202, 5.972; all P〈0.05. non-bone edema patients： serum F=3.513, 3.114, 7.112; synovial fluid F=3.722, 3.965, 8.891; all P〈0.05）. Conclusion IL-1β, IL-6, TNF-a are elevated in osteoarthritis with synov-itis. IL-6 and TNF-a are elevated significantly in knee osteoarthritis with bone marrow edema in particular.