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目的:探讨原发性膝骨关节炎（KOA）患者血清、关节滑液n α-促黑色素细胞刺激激素（n α-MSH）水平与KOA病变程度的相关性。n 方法:回顾性分析2018年10月到2019年10月在惠州市第一人民医院骨科诊断为原发性KOA的96例患者资料（设为KOA组）。影像学严重程度由Kellgren-Lawrence(K-L)分级确定。采用酶联免疫吸附试验（ELISA）测量血清及关节骨液中n α-MSH水平，并测定关节滑液白细胞介素1n β（IL-1n β）和基质金属蛋白酶-3(MMP-3）的水平。同时选取年龄和性别匹配的髌骨脱位患者64例作为对照组。应用数字疼痛量表（NPS）和修订版牛津膝关节评分（OKS）评估症状严重程度。采用受试者工作特征曲线（ROC）分析比较n α-MSH、IL-1n β和MMP-3用于K-L等级的诊断价值。n 结果:两组患者年龄、性别、体重指数比较差异均无统计学意义（n P>0.05)，具有可比性。KOA组患者关节滑液中的n α-MSH水平显著低于对照组[(16.9±3.8）pg/mL n vs.（18.8±2.7 pg/mL）]，差异有统计学意义（n P0.05)。关节滑液n α-MSH水平与K-L分级、NPS评分均呈负相关性(n r=-0.382，n P<0.001；n r=-0.382，n P<0.001)，与OKS评分呈正相关(n r=0.339，n P< 0.001)。进一步分析表明，关节滑液n α-MSH水平与关节滑液IL-1n β、MMP-3的表达均呈负相关(n r=-0.483，n P<0.001；n r=-0.336，n P 0.05). Then α-MSH levels in synovial fluid were significantly lower in the KOA patients than in the controls [(16.9±3.8) pg/mL versus (18.8±2.7) pg/mL] (n P0.05). Then α-MSH levels in synovial fluid were negatively correlated with K-L grades (n r=-0.382, n P<0.001) and negatively correlated with NPS (n r=-0.382, n P<0.001) but positively correlated with OKS (n r=0.339, n P<0.001). Moreover, then α-MSH levels in synovial fluid were negatively correlated with the IL-1n β levels in synovial fluid (n r=-0.483, n P<0.001) and with the MMP-3 levels in synovial fluid (n r=-0.336, n P< 0.001).n Conclusions:The level of serum n α-MSH may not be correlated with the progression of KOA but the synovial fluid n α-MSH is negatively correlated with the progression of KOA. Therefore, the expression level of n α-MSH in joint synovial fluid can be used as a potential biomarker for assessment of severity of knee osteoarthritis.n