| 杜保平,郝耀,杨自权.关节镜下清理术后曲安奈德联合几丁糖治疗膝骨关节炎的疗效及对血清COMP、FGF2水平的影响.骨科,2026,17(5): 417-421. |
| 关节镜下清理术后曲安奈德联合几丁糖治疗膝骨关节炎的疗效及对血清COMP、FGF2水平的影响 |
| Efficacy of triamcinolone acetonide combined with chitosan after arthroscopic debridement for knee osteoarthritis and its effects on serum cartilage oligomeric matrix protein and fibroblast growth factor 2 levels |
| 投稿时间：2025-12-22 |
| DOI：10.3969/j.issn.1674-8573.2026.05.002 |
| 中文关键词: 关节镜下清理术 曲安奈德 几丁糖 膝骨关节炎 成纤维细胞生长因子2 |
| 英文关键词: Arthroscopic debridement Triamcinolone acetonide Chitosan Knee osteoarthritis Fibroblast growth factor 2 |
| 基金项目:山西省基础研究计划项目（202403021221290） |
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| 中文摘要: |
| 目的 探究经关节镜下清理术后，曲安奈德联合几丁糖治疗膝骨关节炎（KOA）的疗效，及对血清成纤维细胞生长因子2（FGF2）、软骨寡聚基质蛋白（COMP）水平的影响。方法 选取2021年4月至2024年12月在本院接受治疗的106例KOA患者，按随机数字表法分为两组，均采用关节镜下清理术治疗，其中单药治疗组在关节镜清理术后加用医用几丁糖，联合治疗组在单药治疗组的基础上加用曲安奈德治疗。比较两组疗效、血清学指标[肿瘤坏死因子α（TNF-α）、COMP、FGF2]、疼痛视觉模拟量表（VAS）评分、膝关节活动度、骨代谢指标[I型胶原交联羧基端肽（CTX）、骨钙素（BGP）、骨碱性磷酸酶（BALP）]、西安大略麦克马斯特大学（WOMAC）骨关节炎指数、膝关节软骨厚度。结果 联合治疗组总有效率为94.34%，高于单药治疗组的79.25%（P<0.05）；联合治疗组VAS评分、WOMAC评分、COMP、CTX、TNF-α水平低于单药治疗组（P<0.05），BGP、FGF2、关节活动度、BALP水平、膝关节软骨厚度均高于单药治疗组（P<0.05）。结论 关节镜下清理术后曲安奈德联合几丁糖治疗KOA患者具有较好疗效，可有效缓解膝关节疼痛程度，改善膝关节功能，提高关节活动度，抑制炎症因子分泌，下调COMP的表达，抑制软骨病变，并可上调FGF2的表达，保护软骨组织，改善骨代谢水平，有助于骨形成，促进患者恢复。 |
| 英文摘要: |
| Objective To investigate the efficacy of triamcinolone acetonide combined with chitosan after arthroscopic debridement in patients with knee osteoarthritis (KOA), and to evaluate its effects on serum cartilage oligomeric matrix protein (COMP) and fibroblast growth factor 2 (FGF2) levels. Methods A total of 106 KOA patients who received treatment in our hospital from April 2021 to December 2024 were enrolled and randomly assigned to a chitosan group and a combination therapy group according to the random number table method. Both groups underwent arthroscopic debridement. After surgery, the chitosan group received medical chitosan, whereas the combination therapy group received triamcinolone acetonide in addition to medical chitosan. Clinical efficacy, serum indicators [tumor necrosis factor-α (TNF-α), COMP, and FGF2], visual analogue scale (VAS) scores, knee range of motion, bone metabolism markers [type I collagen cross-linked C-terminal peptide (CTX), bone gla protein (BGP), and bone alkaline phosphatase (BALP)], Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and knee cartilage thickness were compared between the two groups. Results The total effective rate was significantly higher in the combination therapy group than in the chitosan group (94.34% vs. 79.25%, P<0.05). Compared with the chitosan group, the combination therapy group had significantly lower VAS scores, WOMAC scores, and serum levels of COMP, CTX, and TNF-α, as well as significantly higher levels of BGP, FGF2, knee range of motion, BALP, and knee cartilage thickness (P<0.05). Conclusion After arthroscopic debridement, triamcinolone acetonide combined with chitosan is effective in patients with KOA. It can relieve knee pain, improve knee function, increase joint range of motion, inhibit inflammatory factor secretion, downregulate COMP levels, alleviate cartilage damage, upregulate FGF2 levels, protect cartilage tissue, improve bone metabolism, promote bone formation, and facilitate patient recovery. |
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