运动方式对膝关节骨性关节炎患者运动功能及关节液中NO、MMPs-9水平影响的研究

关键词：运动功能  膝骨关节炎  一氧化氮  基质金属蛋白酶

Keywords:exercise training  knee osteoarthritis  nitrix oxide  matrix metalloproteinases

摘要：

      摘要 目的：观察不同运动训练方式对膝关节骨性关节炎患者运动功能以及关节液中NO、MMPs的影响。 方法：96例确诊膝关节骨性关节炎患者分成3组，治疗A组（n=33）采用股四头肌多点等长训练，治疗B组(n=28)采用有氧踏车运动训练，对照C组（n=35）进行日常步行训练，3组均予以常规关节腔注射玻璃酸钠治疗，每周1次，共5周。在治疗前，治疗后第1周及第5周，分别检测关节液中NO、MMPs-9的含量；同时评估患者治疗前后疼痛指数VAS以及膝关节运动功能LKSS、Lysholm膝关节功能评分量表（Lysholm knee score, LKSS） 结果：3组患者治疗前无明显差异。治疗后第1周，关节液NO均有下降(P<0.05)，各组患者疼痛均有缓解(P<0.05)；组间比较无显著差异(P>0.05)；治疗后第5周，关节液中MMPs-9水平A、B两组间比较有显著性差异(P<0.05)，A和B组的运动功能较C组有显著差异(P<0.05)。 结论：有氧踏车运动能够降低膝关节骨性关节炎患者关节液中MMPs、NO含量，提高膝骨性关节炎患者的运动功能，减轻症状。

Abstract:

      Abstract Objective:To observe the influence of different exercise training ways on motor function and NO, MMPs in joint fluid in patients with knee osteoarthritis. Method: Ninty-six patients with diagnosis of knee osteoarthritis were divided into three groups, treatment group A with multi-point isometric training on quadriceps, treatment group B with aerobic treadmill exercise training, control group C daily walking training. All patients in three groups were treated with articular cavity injection of sodium hyaluronate, once a week, a total of 5 weeks. Before treatment, 1 week and 5 weeks after treatment, content of NO and MMPs-9 in joint fluid was detected. VAS and knee joint movement function LKSS were taken. Result: All the parameters had no difference between the three groups before treatment. 1 week after treatment, joint fluid NO decreased (P<0.05), pain （VAS score）relieved (P<0.05) in every group., There was no significant difference between groups (P>0.05), 5 weeks after treatment, plasma levels of MMPs-9 are statistically significant different between groups A and B (P<0.05). The movement function（LKSS score） of group A and B significant different from group C (P<0.05). Conclusion: Aerobic treadmill exercise can reduce MMPs, NO content in joint fluid, improve movement function, relieve arthritis symptoms for patients with knee osteoarthritis.