The Effect Of Sodium Hyaluronate On MDA And SOD Content And The Analysis Of Clinical Efficacy In Patients With Knee Osteoarthritis

Objective: Through testing the malonic dialodehyde (MDA) contentand superoxide dismutase (SOD) content in synovial fluid of kneeosteoarthritis(KOA) before and after injection of sodium hyaluronate（SH）,To explore the possible pathogenesis of KOA，and explore the possiblemechanism of SH being in the treatment of KOA，Evaluating of theclinical efficacy of SH being in the treatment of KOA.Methods: We refer to the Standard of diagnosis of osseous arthritisWhich was made by America rheumatology in1995, to Screen of thepatients with KOA who visited to the Orthopaedics Clinic of our hospital from2012September to2013September, There were37cases with40joints as the object of studies, According to the indication rating results,they were divided into mild group10cases with10joints，moderate group17cases with18joints and severe group10cases with12joints，All patientswere injected of sodium hyaluronate into the knee joint cavity, Injection of1times per week, Each injection of25mg, For5weeks as a course. Accordingto the Japanese knee osteoarthritis indication rating standards, We Assessmentof the severity of the disease by Determining of indication rating and drawingthe synovial fluid of all the patients at before treatment and4weeks aftertreatment, All the patients meet the diagnostic criteria, inclusioncriteria, exclusion criteria, Patients in the three groups was no significant inage, gender differences, knee. Determining of MDA content andSOD content in the synovial fluid in each group by chemical colorimetricmethod, Study on the correlation between the content of malonic dialodehyde（MDA）and superoxide dismutase(SOD) in the synovial fluid of the kneeosteoarthritis (KOA) and the severity of KOA，To explore the relationship between the contents of MDA and the contents of SOD in synovial fluid ofKOA，and To analysis the clinical analysis of sodium hyaluronate in thetreatment of KOA.Results: The average content of MDA in synovial fluid ofKOA before injection of SH was6.80±1.12(nmol/ml), The averageindication rating was16.48±6.39, The statistical results show that the MDAcontent in synovial fluid of KOA was positively correlated with theindication rating， the Pearson correlation coefficient was0.667，P=0.000.The average content of SOD in synovial fluid of KOA before injectionof SH was81.61±14.73(nU/ml), The average indication rating was16.48±6.39, The statistical results show that the SOD content in synovial fluidof KOA was negatively correlated with the indication rating， thePearson correlation coefficient was-0.621，P=0.000. The MDA content wasnegatively correlated with the SOD content in synovial fluid of KOA beforeinjection of SH，the Pearson correlation coefficient was-0.336，P=0.034.The MDA content in synovial fluid of KOA before injection,mild groupwas5.84±1.04(nmol/ml)、moderate group was6.87±0.89(nmol/ml)、severegroup was7.48±0.99(nmol/ml)，4weeks after injection, mild group was5.13±0.84(nmol/ml)、moderate group was5.96±0.76(nmol/ml)、severegroup was6.85±0.89(nmol/ml)，the statistical results show that the MDAcontent in synovial fluid4weeks after injection was decreased thanbefore injection, The P value were0.000、0.000、0.010, The difference wasstatistically significant (P<0.05). The SOD content in synovial fluid ofKOA before injection,mild group was93.70±12.15(nU/ml)、moderate groupwas82.50±11.40(nU/ml)、severe group was70.20±13.08(nU/ml)，4weeksafter injection mild group was99.29±12.18(nU/ml)、moderate group was86.71±10.62(nU/ml)、severe group was72.91±12.50(nU/ml)，the statisticalresults show that the content of SOD in synovial fluid4weeksafter injection was increased than before injection, the P values were0.006、0.000、0.000, the difference was statistically significant (P <0.05). Theindication rating results before injection mild group was7.80±1.23、moderate group was16.39±2.77、severe group was23.83±1.99，4weeks after injectionmild group was2.60±2.06、moderate group was11.89±4.57、severe group was22.83±6.55, The statistical results show that the indication rating results ofmild group and moderate group4weeks after injection were decreased thanbefore injection，the P value were0.000、0.000，the difference was statisticallysignificant (P<0.05), the indication rating result of severe group4weeksafter injection was no significant decrease than before injection，the P valuewas0.512，The difference was no statistically significant (P <0.05).Conclusions:1The MDA content in synovial fluid of KOA wasPositively correlated with the indication rating of KOA, The SOD contentin synovial fluid of KOA was negatively correlated with theindication rating of KOA, The content of oxygen free radicals was positivelycorrelated with the severity of KOA, Oxygen free radicals maybe played animportant role in the development of KOA.2The MDA content was negatively correlated with the SOD content insynovial fluid of KOA，The generation and clearance balance of oxygen freeradical was destroyed maybe played an important role in the development ofKOA.3Sodium hyaluronate could reduce the content of oxygen free radical insynovial fluid of KOA, which maybe may be one of themechanisms of treatment of KOA. Further more sodium hyaluronate wasmore suitable for treatment mild to moderate KOA.