| Objective: Knee Osteoarthritis (KOA) is a common and frequentlyencountered disease in the elderly. In the early stage, patients with KOA maymanifest arthralgia, tumidness and claudication, have difficulty in goingupstairs and downstairs, and feel pain in the knee-joint while walking. In thelater period, it may manifest as deformation and dysfunction of the knee-joint,leading to disability, which seriously impact quality of life. As the mostcommon joint disease leading to pain and dysfunction in the world, it caninvolve articulatio coxae, articulatio genus, and facet joint of palm, whileknee-joint is the most common. The course of KOA is long, and the state ofillness may come over and over again. There is no medicine curing the disease,so far. The purpose is to relieve pain, prevent or postpone the advancing ofdisease, and protect the function of the joints. As KOA is a disease involvingcartilago articularis and synovial membrane, we have a nice therapeutic effecton treating the disease with injecting Sodium Hyaluronate(SH) intointra-articular. By observing the change of the content of nitric oxide (NO)、the thickness of synovium、and clinical efficacy of grading, To explore the NOcontent, synovial membrane thickness on the effect of KOA. SH effects NOcontent, synovial thickness, and clinical, which provides theoretical andclinical basis for drug efficacy evaluation.Methods: Reference to KOA diagnosis standards promulgated by theAmerican rheumatism association in1995, To select patients from September2012to September2013in our hospital orthopaedic outpatient, totally80patients86knee joints. According to Japan’s knee osteoarthritis indicationsrating criteria, there were40cases of40knees in the mild group,28cases of31knees in the moderate group,12cases of15knees in the serious group. All patients were treated with SH into intra-articular, once a week,25mg perinjection, and5weeks as a course of treatment. Observe synovial fluid andthickness of synovium before treatment and after4weeks. Patients extractingsynovial fluid and accomplishing ultrasound were deemed as a completemonitoring group. There were10cases of10knees in the mild group,17casesof18knees in the moderate group,10cases of12knees in the serious group.The content of NO and thickness of synovium were measured by chemicalcolorimetry and ultrasound, and all KOA patients were graded according toJapan’s knee osteoarthritis indications rating criteria before treatment,4weeks,and12weeks. All the data were analysesed by SPSS.Results:(1) all patients with KOA after4weeks treatment by SH, theeffective rate were92.5%、77.4%、46.7%in mild、moderate、serious group，total effective rate were79.1%. after12weeks treatment by SH, the effectiverate were95%、83.9%、33.3%in mild、moderate、serious group，totaleffective rate were80.2%.(2) all patients with KOA after4weeks、12weekstreatment compared with treatment ago in mild、moderate group，after12weeks treatment compared with after4weeks，have statistical significance（P＜0.05）. after4weeks、12weeks treatment compared with treatment ago inserious group，after12weeks treatment compared with after4weeks，have nostatistical significance（P＞0.05）.(3) In KOA complete monitoring group,after4weeks treatment compared with treatment ago in mild、moderate、serious group, NO was markedly reduced, the difference was statisticallysignifican（tP＜0.05）. after4weeks treatment compared with treatment ago inmild、serious group, synovial thickness was no obvious change, the differencewas no statistically significant（P＞0.05）. but in moderate group, synovialthickness was decreased, the difference is statistically significant（P＜0.05）.(4) In KOA complete monitoring group, NO and indications rating werepositively correlated, Pearson correlation coefficient was0.57, P=0.0001.synovial thickness and indications rating were positively correlated, Pearsoncorrelation coefficient was0.49, P=0.001. NO and synovial membranethickness were positively correlated, Pearson correlation coefficient was0.73, P=0.0001.(5) In KOA complete monitoring group, NO in mild groupdecrease degree is better than in serious group, the difference was statisticallysignificant（P＜0.05）. However, there is no statistically significant betweenmild and moderate group（P＞0.05）. synovial thickness decrease degreeamong three groups, there is no statistically significan（tP＞0.05）. indicationsrating in mild and moderate group decrease degree is better than in seriousgroup, the difference was statistically significan（tP＜0.05）. However, there isno statistically significant between mild and moderate group（P＞0.05）.Conclusion:(1) NO concentration、synovial thickness and indicationsrating have correlation in patients with KOA.(2) SH treat KOA can effect NOlevels in knee joint fluid、synovial thickness and indications rating.(3) SH canreduce NO concentration、synovial thickness、improve the clinical symptomsand score in mild and moderate KOA patients, SH is suitable for mild andmoderate KOA patients，it has a reliable curative effect. |
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