摘要
目的探究分析2型糖尿病患者夏科氏关节病的病理机制。方法以冀中能源峰峰集团总医院2018年6月~2019年6月收治的10例夏科氏关节病患者作疾病组,以10例健康者作健康组,于体外对软骨细胞进行培养,并对细胞凋亡率、细胞中活性氧水平、蛋白聚糖(Aggrecan)、核因子κB受体活化因子配体(RANKL)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、护骨素(OPG)及白细胞介素6(IL-6)表达进行测定;透射电镜法观察两组软骨组织的超微结构。结果疾病组软骨细胞组织中的线粒体呈现出肿胀状态,且部分线粒体膜的结构缺乏完整性,高尔基体、内质网均呈严重肿胀状,线粒体嵴的排列较为紊乱,软骨细胞核的体积明显增大,同时染色质断裂、浓缩,可见核膜边缘处有染色质大量聚集。疾病组软骨细胞组织的RANKL、TNF-α、IL-1β及IL-6表达高于健康组,疾病组Aggrecan及OPG表达低于健康组,差异均有统计学意义(P<0.05);疾病组软骨细胞组织凋亡率、软骨细胞中活性氧水平高于健康组,差异均有统计学意义(P<0.05)。结论2型糖尿病患者夏科氏关节病变病理特征为细胞破坏及软骨结构破坏,炎症反应在该疾病的发生中也存在一定作用。
Objective To analyze the pathological mechanism of Charcot arthropathy in patients with type 2 diabetes.Methods Ten patients with Charcot arthropathy who were treated in General Hospital of Jizhong Energy Fengfeng Group from June 2018 to June 2019 were as the disease group,10 healthy adults as the health group.The cartilage cells were cultured in vitro,and the apoptotic rate,the levels of active oxygen,aggrecan,receptor activator of nuclear factor kappa B ligand(RANKL),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),osteoprotegerin(OPG),interleukin-6(IL-6)were measured.The ultrastructure of cartilage in the two groups was observed by transmission electron microscope.Results The mitochondria in the chondrocytes of the disease group were swollen,and some mitochondrial membranes lacked integrity.The Golgi apparatus and endoplasmic reticulum were severely swollen.The arrangement of mitochondrial cristae was disordered.The volume of chondrocyte nucleus increased significantly,the chromatin was broken and condensed,and a large amount of chromatin gathered at the edge of nuclear membrane.The levels of RANKL,TNF-α,IL-1βand IL-6 in chondrocytes of the disease group were higher than those of the health group,while the levels of aggrecan and OPG of the disease group were lower than those of the health group,there were significant differences between the two groups(P<0.05).The apoptotic rate of chondrocytes,the level of reactive oxygen species in the disease group were higher than those in the health group,there were significant differences between the two groups(P<0.05).Conclusion The pathological features of Charcot arthropathy in patients with type 2 diabetes are characterized by destruction of chondrocytes and destruction of cartilage structure.The inflammatory response plays a key role in the pathogenesis of the disease.
作者
李敏
李扬
李娟
苏军华
Li Min;Li Yang;Li Juan;Su Junhua(General Hospital of Jizhong Energy Fengfeng Group,Handan 056000;The Second Hospital of Hebei Medical University,Shijiazhuang 050000;The 980th Hospital of the Chinese People's Liberation Army Joint Logistics Support Forces,Shijiazhuang 050000)
出处
《国际老年医学杂志》
2022年第3期293-298,共6页
International Journal of Geriatrics
基金
河北省医学科学研究重点课题计划(20170120)。
关键词
2型糖尿病
夏科氏关节病
病理机制
Type 2 diabetes
Charcot arthropathy
Pathological mechanism
Pathological features
