2型糖尿病合并肩袖损伤患者肩关节滑液TNF-α及LTB4表达与疼痛及功能的相关性

doi:10.3969/j.issn.1006-6233.2025.12.022

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摘要 目的: 探讨2型糖尿病合并肩袖损伤患者术前肩关节滑液中肿瘤坏死因子-α(TNF-α)及白三烯B4(LTB4)的表达及其与肩关节疼痛和功能的相关性。方法: 前瞻性纳入2024年1月至2025年3月承德市中心医院收治的68例肩袖损伤并行关节镜手术治疗的患者,根据是否合并2型糖尿病分为糖尿病组(n=32)和非糖尿病组(n=36)。采用酶联免疫吸附试验(ELISA)检测两组患者肩关节滑液TNF-α、LTB4水平的差异,评估并比较两组术前肩关节疼痛VAS评分、美国肩肘医师协会(ASES)评分及Constant肩关节评分的差异,采用Pearson相关分析各评分与肩关节滑液TNF-α、LTB4的相关性。结果: 两组性别、年龄、体重指数、侧别及撕裂大小等一般资料比较无统计学意义(P>0.05)。糖尿病组肩关节滑液TNF-α、LTB4及VAS评分均高于非糖尿病组,ASES评分及Constant评分均低于非糖尿病组,差异均有统计学意义(P<0.05)。68例肩袖损伤患者术前VAS评分与肩关节滑液TNF-α、LTB4水平呈正相关(P<0.05);术前ASES评分、Constant评分与肩关节滑液TNF-α、LTB4水平均呈负相关(P<0.05)。结论: 肩袖损伤合并2型糖尿病患者术前肩关节滑液TNF-α、LTB4水平显著升高,且与关节疼痛呈正相关、与功能评分呈负相关,提示糖尿病可能加重肩袖损伤患者肩关节局部的炎症反应,加剧疼痛和功能障碍。

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关键词 ：肩袖损伤, 2型糖尿病, 肿瘤坏死因子-α, 白三烯B4

Abstract：Objective: To investigate the expression of tumor necrosis factor-α (TNF-α) and leukotriene B4 (LTB4) in the synovial fluid of the shoulder joints of patients with type 2 diabetes mellitus combined with rotator cuff injuries preoperatively and their correlation with shoulder pain and function. Methods: Sixty-eight patients with rotator cuff injuries treated with concurrent arthroscopic surgery admitted to Chengde City Central Hospital from January 2024 to March 2025 were prospectively included and divided into diabetic (n=32) and non-diabetic (n=36) groups according to whether they had type 2 diabetes mellitus. Enzyme-linked immunosorbent assay (ELISA) was used to detect the differences in the levels of TNF-α and LTB4 in the synovial fluid of the shoulder joints of the patients in the two groups, and to evaluate and compare the differences in the preoperative VAS scores of shoulder pain, the American Society of Shoulder and Elbow Surgeons (ASES) scores, the Constant Shoulder Score of the two groups, and the correlations between each score and TNF-α and LTB4 in the synovial fluid of the shoulder joints were analyzed by Pearson correlation-the correlation between each score and shoulder synovial fluid TNF-α, LTB4. Results: There was no statistical significant difference in the general information such as gender, age, body mass index, injury side, and tear size between the two groups (P>0.05). In the diabetic group, shoulder synovial fluid TNF-α, LTB4, and VAS scores were higher than those in the nondiabetic group, and ASES and Constant scores were lower than those in the nondiabetic group, and the differences were statistically significant (P<0.05). There is a positive correlation between the preoperative VAS scores and the levels of synovial fluid TNF-α and LTB4 in the shoulder joint among the 68 patients with rotator cuff injuries (P<0.05); preoperative ASES score and Constant score were negatively correlated with shoulder synovial fluid TNF-α and LTB4 levels (P<0.05). Conclusion: In patients with rotator cuff injury combined with type 2 diabetes mellitus, the preoperative levels of TNF-α and LTB4 in the synovial fluid of the shoulder joint were significantly elevated and positively correlated with joint pain and negatively correlated with functional scores, suggesting that diabetes mellitus may exacerbate localized inflammatory responses in the shoulder joint of rotator cuff injury patients and aggravate the pain and dysfunction.

Key words： Rotator cuff injury Type 2 diabetes Tumor necrosis factor-α Leukotriene B4

基金资助:承德市科研应用技术与开发项目,(编号:202305B076);2020年河北省医学科学研究指导性课题,(编号:20200394)

通讯作者: 于力

引用本文:

陈涛, 白冰, 孟繁杰, 何建秋, 于力. 2型糖尿病合并肩袖损伤患者肩关节滑液TNF-α及LTB4表达与疼痛及功能的相关性[J]. 河北医学, 2025, 31(12): 2073-2078.
CHEN Tao, et al. Correlation of Shoulder Synovial Fluid TNF-α and LTB4 Expression with Pain and Function in Patients with Type 2 Diabetes Mellitus Combined with Rotator Cuff Injury. HeBei Med, 2025, 31(12): 2073-2078.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.12.022 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I12/2073

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