ヒアルロン酸関節腔内注入による関節液マーカーの変動と臨床効果 : 特にプロスタグランディンE_2濃度からみた抗炎症効果について
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Fifty-eight patients with osteoarthritis of the knee who showed a relatively mild deformity on the X-rays associated with hydrarthrosis and pain on exercise were administered high molecular weight sodium hyaluronate (SPH; average molecular weight, 800,000) by injection into the knee joint, once a week for 5 consecutive weeks. Synovial fluid was withdrawn by puncture prior to each injection and biochemically analyzed. The relations between the biochemical findings and the clinical efficacy as assessed by the knee score established by the Japanese Orthopedic Association (JOA), the visual analogue scale (VAS) and the patient's impression were studied. After treatment, not only the amount of synovial fluid but also the synovial fluid markers, such as chondroitin 6-sulfate OS), chondroitin 4-sulfate (C4S), C6S/C4S ratio, prostaglandin E_2 (PGE_2), etc, were significantly decreased, while type II procollagen C-peptide (pCOL II-C) was significantly increased. The decrease in the amount of synovial fluid and in PGE_2 strongly suggested that SPH had had an anti-inflammatory effect inside the articular cavity. The decrease in C6S and the increase in pCOL II-C suggested that SPH had both suppressed cartilage impairment and contributed to its repair. Of the synovial fluid markers, the decrease in C6S and in C4S correlated well with the degree of articular pain relief in terms of variations in JOA knee score and VAS. These findings suggested that the presence of a cartilage-repairing mechanism and the improvement in synovitis might be important for articular pain relief. Based on the decrease in PGE_2 found in this study and on a report on the effect of SPH on arachidonic acid metabolism by other investigators, it was inferred that SPH would exert an inhibitory effect on arachidonic acid metabolism.
- 東京女子医科大学の論文
- 1998-02-25
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- ヒアルロン酸関節腔内注入による関節液マーカーの変動と臨床効果 : 特にプロスタグランディンE_2濃度からみた抗炎症効果について
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- ヒアルロン酸関節腔内注入による関節液マーカーの変動と臨床効果 : 特にプロスタグランディンE_2濃度からみた抗炎症効果について(学位論文内容の要旨および審査の結果の要旨 第38集(平成11年5月))