陕西医学杂志2025，Vol.54Issue(12)：1628-1634,7.DOI:10.3969/j.issn.1000-7377.2025.12.007
代谢综合征通过脂肪-炎症-凝血轴对全膝关节置换术围手术期的影响
Impact of MetS on perioperative period of TKA through adipose-inflammation-coagulation axis
摘要
Abstract
Objective:To investigate the impact of metabolic syndrome(MetS)on the perioperative period of to-tal knee arthroplasty(TKA)through the adipose tissue-mediated inflammation-coagulation cascade reaction.Meth-ods:A total of 122 patients with simple knee osteoarthritis(KOA)(simple KOA group)and 57 KOA patients with MetS(MetS-KOA group)were enrolled.The differences in adipose tissue morphology,synovial macrophage polari-zation,inflammatory indicators,coagulation function,and clinical outcomes were compared and analyzed between the two groups.Results:Compared with the simple KOA group,the diameter of infrapatellar adipose tissue lobules in the MetS-KOA group increased,the positive rate of crown-like structures(CLS)and the leptin level in adipose tissue in-creased(all P<0.05);the ratio of M1/M2 macrophages and the level of tumor necrosis factor-α(TNF-α)in synovial tissue increased,while the level of serum interleukin-6(IL-6)also rose(all P<0.05);on the first day after surgery,the D-dimer level and the incidence of venous thrombosis significantly increased(all P<0.05).Correlation analysis showed that leptin level was positively correlated with M1 polarization of macrophages(r=0.318,P<0.05),and se-rum D-dimer level on the first postoperative day was positively correlated with synovial TNF-αlevel(r=0.518,P<0.05).Conclusion:MetS activates the adipose-synovium inflammation axis through adipose lobule hypertrophy and inflammatory infiltration,and exacerbates coagulation disorders through systemic inflammatory responses,signifi-cantly affecting the perioperative prognosis of TKA.关键词
代谢综合征/全膝关节置换术/脂肪组织/炎症反应/凝血功能/瘦素Key words
Metabolic syndrome/Total knee arthroplasty/Adipose tissue/Inflammatory response/Coagulation function/Leptin分类
医药卫生引用本文复制引用
许东升,危一飞,蒋科卫,郑仲洲,张光熠..代谢综合征通过脂肪-炎症-凝血轴对全膝关节置换术围手术期的影响[J].陕西医学杂志,2025,54(12):1628-1634,7.基金项目
国家自然科学基金青年科学基金资助项目(82305277) （82305277）
