«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:

第34卷

期数:

2026年05期

页码:

32-38

栏目:

临床研究

出版日期:

2026-05-10

文章信息/Info

Title:

Correlation Analysis of Muscle Bone Ultrasound Combined with Cartilage Metabolic Markers on Cartilage Injury in Knee Osteoarthritis

文章编号:

1005-0205(2026)05-0032-07

作者:

黄勇嘉 潘天孟 谭扬 金涛 姚尉

¹宜宾市第一人民医院(四川 宜宾,644000)
²三六三医院

Author(s):

HUANG Yongjia¹; PAN Tianmeng¹; TAN Yang¹; JIN Tao¹; YAO Wei^2△

¹The First People's Hospital of Yibin,Yibin 644000,Sichuan China; ²363 Hospital,Chengdu 610041,China.

关键词:

肌骨超声;  膝骨关节炎;  软骨损伤;  软骨代谢标志物;  诊断价值;  严重程度

Keywords:

musculoskeletal ultrasound;  knee osteoarthritis;  cartilage injury;  markers of cartilage metabolism;  diagnostic value;  severity

分类号:

R684.3

DOI:

10.20085/j.cnki.issn1005-0205.260505

文献标志码:

A

摘要:

目的:探讨肌骨超声检查联合软骨代谢标志物对膝骨关节炎合并软骨损伤的诊断价值及其与严重程度的相关性。方法:回顾性分析2022年5月至2025年4月收治的96例症状性膝骨关节炎患者资料,根据入院后关节镜检查结果,分为合并软骨损伤组(n=45)和单纯膝骨关节炎组(n=51)。通过肌骨超声检查对股骨滑车软骨形态、髌上囊积液深度、滑膜血流信号及股骨髁/胫骨平台骨赘形成情况进行半定量评分,并计算肌骨超声检查总分。ELISA法测定血清Ⅱ型胶原羧基端端肽(CTX-Ⅱ)、软骨寡聚基质蛋白(COMP)及基质金属蛋白酶-3(MMP-3)水平。对膝骨关节炎合并软骨损伤影响因素进行单因素和多因素Logistic回归分析,采用受试者工作特征曲线评估肌骨超声检查联合软骨代谢标志物对膝骨关节炎合并软骨损伤的诊断价值。所有患者入院后均接受关节镜检查,采用Outerbridge分级评估软骨损伤严重程度,将Ⅰ级和Ⅱ级定义为轻度损伤(n=23),Ⅲ级定义为中度损伤(n=14),Ⅳ级定义为重度损伤(n=8),分析肌骨超声检查总分及软骨代谢标志物与膝骨关节炎合并软骨损伤严重程度的相关性。结果:合并软骨损伤组软骨形态、积液深度、滑膜血流、骨赘评分及肌骨超声检查总分均显著大于单纯膝骨关节炎组,差异有统计学意义(P<0.05)。合并软骨损伤组血清CTX-Ⅱ、COMP、MMP-3水平均显著高于单纯膝骨关节炎组,差异有统计学意义(P<0.05)。肌骨超声检查总分及血清CTX-Ⅱ、COMP、MMP-3水平是膝骨关节炎合并软骨损伤的危险因素,差异有统计学意义(P<0.05)。肌骨超声检查和软骨代谢标志物联合诊断的曲线下面积(AUC)显著高于单项指标,且联合指标越多AUC越高,其中肌骨超声检查总分+CTX-Ⅱ+COMP+MMP-3水平诊断效能最高(AUC为0.952),显著高于两项及三项指标联合的诊断效能,差异有统计学意义(P<0.05)。随着软骨损伤程度加重,肌骨超声检查总分及血清CTX-Ⅱ、COMP、MMP-3水平均呈逐渐升高趋势,不同严重程度组别上述指标比较,差异均有统计学意义(P<0.05)。肌骨超声检查总分及血清CTX-Ⅱ、COMP、MMP-3水平均与Outerbridge分级显著正相关,差异有统计学意义(P<0.05)。结论:膝骨关节炎合并软骨损伤患者股骨滑车软骨形态、髌上囊积液深度、滑膜血流信号、股骨髁/胫骨平台骨赘及血清软骨代谢标志物水平较单纯膝骨关节炎患者显著改变,肌骨超声检查联合软骨代谢标志物水平对膝骨关节炎合并软骨损伤具有较高诊断价值,且与软骨损伤严重程度显著相关,可为临床诊疗提供可靠依据。

Abstract:

Objective:To explore the diagnostic value of musculoskeletal ultrasound(MSUS)combined with cartilage metabolism markers for cartilage injury in knee osteoarthritis(KOA)and to investigate its correlation with disease severity.Methods:A retrospective analysis was conducted on the data of 96 patients with symptomatic KOA from May 2022 to April 2025.According to the arthroscopic examination results obtained after admission,they were divided into the group with cartilage injury(n=45)and the group with simple KOA(n=51).The morphology of femoral trochlear cartilage,the depth of suprapatellar bursa effusion,synovial blood flow signals and the formation of osteophytes at the femoral condyle/tibial plateau were assessed semi-quantitatively using MSUS examination,and the total scores of MSUS were calculated.The levels of serum type Ⅱ collagen carboxyl-terminal peptide(CTX-Ⅱ),cartilage oligomeric matrix protein(COMP),and matrix metalloproteinase-3(MMP-3)were determined by ELISA.Univariate and multivariate Logistic regression analyses were conducted to identify factors associated with KOA complicated by cartilage injury.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of musculoskeletal ultrasound combined with cartilage metabolic markers for KOA with concurrent cartilage injury.All patients underwent arthroscopic examination after admission.The severity of cartilage injury was evaluated using the Outerbridge classification.Grade Ⅰ and Ⅱ were defined as mild injury(n=23),grade Ⅲ as moderate injury(n=14),and grade Ⅳ as severe injury(n=8).To analyze the correlation between the total scores of MSUS and cartilage metabolism markers and the severity of cartilage injury in patients with KOA.Results:The cartilage morphology,effusion depth,synovial blood flow,osteophyte scores and total MSUS scores in the combined cartilage injury group were significantly greater than those in the simple KOA group(P<0.05).The levels of serum CTX-Ⅱ,COMP and MMP-3 in the combined cartilage injury group were significantly higher than those in the simple KOA group(P<0.05).The total scores of MSUS and serum CTX-Ⅱ,COMP,and MMP-3 were identified as risk factors for KOA combined with cartilage injury(P<0.05).The area under the curve(AUC)of the combined diagnosis of musculoskeletal ultrasound and cartilage metabolism markers was significantly higher than that of individual indicators.Moreover,the more combined indicators there were,the higher the AUC.Among them,the total scores of MSUS +CTX-Ⅱ+COMP+MMP-3 had the highest diagnostic efficacy,with an AUC of 0.952,which was significantly higher than the diagnostic efficacy of the combination of two and three indicators(P<0.05).With the aggravation of cartilage injury,the total scores of MSUS and the levels of serum CTX-Ⅱ,COMP,and MMP-3 all showed a gradually increasing trend.Comparisons of the above indicators across different severity groups showed statistically significant differences(P<0.05).The total scores of MSUS and the levels of serum CTX-Ⅱ,COMP and MMP-3 were all significantly positively correlated with the Outerbridge grade(P<0.05).Conclusion:The morphology of femoral trochlear cartilage,the depth of supatellar bursa effusion,synovial blood flow signals,osteophytes at the femoral condyle/tibial plateau,and the levels of serum cartilage metabolism markers in patients with KOA combined with cartilage injury are significantly changed compared with those with simple KOA.MSUS combined with cartilage metabolism markers exhibits high diagnostic value for KOA combined with cartilage injury and shows a significant correlation with the severity of cartilage injury.It can provide a reliable basis for clinical diagnosis and treatment.

备注/Memo

备注/Memo:

基金项目:四川省医学会2024年度医学科研项目和青年创新项目(S2024073)
^△通信作者 E-mail:yzf090403@163.com

常用功能

更新日期/Last Update: 2026-05-15