基于多源数据融合的骨关节炎分子分型体系构建的临床机制研究

注册号:

Registration number:

ChiCTR2500106198 

最近更新日期:

Date of Last Refreshed on:

2025-07-21 08:20:34 

注册时间:

Date of Registration:

2025-07-21 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

基于多源数据融合的骨关节炎分子分型体系构建的临床机制研究

Public title:

Clinical Mechanism Study on the Construction of Molecular Typing System for Osteoarthritis Based on Multi-source Data Fusion

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于多源数据融合的骨关节炎分子分型体系构建的临床机制研究

Scientific title:

Clinical Mechanism Study on the Construction of Molecular Typing System for Osteoarthritis Based on Multi-source Data Fusion

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

李承恩 

研究负责人:

杨振国 

Applicant:

Chengen LI 

Study leader:

Zhenguo Yang 

申请注册联系人电话:

Applicant telephone:

+86 186 6077 5936

研究负责人电话:

Study leader's
telephone:

+86 137 9100 6238

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

425736706@qq.com

研究负责人电子邮件:

Study leader's E-mail:

Yangzhenguo81@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

济南市经八路1号

研究负责人通讯地址:

济南市经八路1号

Applicant address:

No. 1, Jingba Road, Jinan City

Study leader's address:

No. 1, Jingba Road, Jinan City

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

山东中医药大学第二附属医院

Applicant's institution:

Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine

研究负责人所在单位:

山东中医药第二附属医院

Affiliation of the Leader:

Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2025 伦审-KY-040

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

山东中医药大学第二附属医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine

伦理委员会批准日期:

Date of approved by ethic committee:

2025-06-30 00:00:00

伦理委员会联系人:

袁媛

Contact Name of the ethic committee:

Yuanyuan

伦理委员会联系地址:

济南市经八路1号

Contact Address of the ethic committee:

No. 1, Jingba Road, Jinan City

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 531 8243 6062

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

山东中医药大学第二附属医院

Primary sponsor:

the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine

研究实施负责(组长)单位地址:

济南市经八路1号

Primary sponsor's address:

No. 1, Jingba Road, Jinan City

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

山东

市(区县):

济南

Country:

CHINA

Province:

Shandong

City:

Jinan

单位(医院):

山东中医药大学第二附属医院

具体地址:

济南市经八路1号

Institution
hospital:

the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine

Address:

No. 1, Jingba Road, Jinan City

经费或物资来源:

自筹

Source(s) of funding:

self-funded

研究疾病:

骨关节炎  

Target disease:

osteoarthritis

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

I期临床试验 

Study phase:

1

研究设计:

病例对照研究 

Study design:

Case-Control study 

研究目的:

构建基于多源数据融合的骨关节炎精准分型体系:通过整合临床表现(疼痛、晨僵、影像学分级)、影像组学特征(软骨厚度、骨赘体积分数)、血液代谢组学标志物及空间转录组学数据,建立多维度的骨关节炎(OA)分子分型标准,突破传统ACR/EULAR分型对早期病变识别率低(57%-74%)的局限。揭示亚型特异性分子机制:结合显微切割技术、单细胞测序及空间蛋白组学,揭示不同OA亚型(如滑膜炎症型、代谢异常型、机械应力型)的时空异质性特征,挖掘软骨下骨内血管内皮细胞、成骨/破骨细胞耦联失衡的关键调控分子网络,阐明亚型特异性病理机制。 膝骨关节炎(knee osteoarthritis,KOA)是一种以关节软骨退行性病变为核心,伴随软骨下骨硬化、骨赘形成、滑膜炎症及关节囊纤维化的慢性退行性关节疾病。其发生与年龄、肥胖、机械负荷异常、代谢紊乱及遗传易感性等多因素相互作用密切相关,是力学失衡与生物学改变共同驱动的复杂病理过程。随着人口老龄化加剧及肥胖率持续攀升,KOA全球患病率显著上升,且呈现年轻化趋势,已成为导致中老年人肢体功能障碍、致残的主要疾病之一,严重影响患者生活质量和社会经济负担。临床治疗主要采用非甾体抗炎药、关节腔糖皮质激素注射、透明质酸替代疗法及人工关节置换术等手段,但这些方法仅能暂时缓解疼痛或进行终末期结构修复,无法阻止软骨退变进程,且长期用药可能引发胃肠道损伤、心血管风险等并发症。当前诊断高度依赖X线显示的关节间隙狭窄和骨赘形成等结构性改变,然而研究表明,影像学表现与临床症状严重程度常不完全吻合,早期软骨损伤在常规影像学中难以识别,约40%的膝关节疼痛患者影像学表现正常。此外,代谢异常、炎症因子(如IL-1β、TNF-α)及软骨降解标志物(如CTX-II、COMP)的动态变化提示KOA存在复杂的分子机制。因此,探索关节液、血液或影像组学中的特异性生物标志物,阐明力学应力与细胞外基质代谢调控的分子网络,对实现KOA早期预警、精准分型及靶向治疗具有重大意义。  

Objectives of Study:

Constructing a precise typing system for osteoarthritis based on multi-source data fusion: By integrating clinical manifestations (pain, morning stiffness, imaging grading), radiomics features (cartilage thickness, osteophyte volume fraction), blood metabolomics markers, and spatial transcriptomics data, a multi-dimensional molecular typing standard for osteoarthritis (OA) will be established. This aims to break through the limitation of the traditional ACR/EULAR typing, which has a low recognition rate (57%-74%) for early lesions. Revealing subtype-specific molecular mechanisms: Combining laser capture microdissection, single-cell sequencing, and spatial proteomics, the spatiotemporal heterogeneity characteristics of different OA subtypes (such as synovial inflammation subtype, metabolic disorder subtype, and mechanical stress subtype) will be revealed. The key regulatory molecular networks involved in the imbalance of vascular endothelial cells in subchondral bone and the coupling of osteoblasts/osteoclasts will be explored, and the subtype-specific pathological mechanisms will be clarified. Knee osteoarthritis (KOA) is a chronic degenerative joint disease centered on articular cartilage degeneration, accompanied by subchondral bone sclerosis, osteophyte formation, synovial inflammation, and joint capsule fibrosis. Its occurrence is closely related to the interaction of multiple factors such as age, obesity, abnormal mechanical load, metabolic disorder, and genetic susceptibility, and it is a complex pathological process driven by both mechanical imbalance and biological changes. With the of population aging and the continuous rise in obesity rates, the global prevalence of KOA has increased significantly, showing a younger trend. It has become one of the main diseases causing limb dysfunction and disability in middle-aged and elderly people, seriously affecting patients' quality of life and imposing a heavy social and economic burden. Clinical treatments mainly include non-steroidal anti-inflammatory drugs, intra-articular glucocorticoid injections, hyaluronic acid replacement therapy, and artificial joint replacement. However, these methods can only temporarily relieve pain or perform end-stage structural repair, failing to stop the process of cartilage degeneration. Moreover, long-term medication may cause complications such as gastrointestinal damage and cardiovascular risks. Current diagnosis is highly dependent on structural changes shown by X-rays, such as joint space narrowing and osteophyte formation. However, studies have shown that imaging findings are often not completely consistent with the severity of clinical symptoms. Early cartilage damage is difficult to identify in conventional imaging, and about 40% of patients with knee pain have normal imaging findings. In addition, dynamic changes in metabolic abnormalities, inflammatory factors (such as IL-1β, TNF-α), and cartilage degradation markers (such as CTX-II, COMP) suggest that KOA has complex molecular mechanisms. Therefore, exploring specific biomarkers in synovial fluid, blood, or radiomics, and clarifying the molecular network regulating mechanical stress and extracellular matrix metabolism are of great significance for achieving early warning, precise typing, and targeted therapy of KOA.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.有精神疾病或不能配合患者; 2.既往对本研究所使用药物过敏患者; 3.已接受过其他治疗,会对本研究产生干扰的患者; 4.具有严重基础疾病、感染性疾病等手术禁忌症;

Exclusion criteria:

1. Patients with mental illness or inability to cooperate; 2. Patients who have been allergic to the drugs used in this study in the past; 3. Patients who have received other treatments that will interfere with this study; 4. Have serious underlying diseases, infectious diseases and other surgical contraindications;

研究实施时间:

Study execute time:

From 2025-06-30 00:00:00 To 2026-06-29 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-07-21 00:00:00 To 2026-06-29 00:00:00

干预措施:

Interventions:

组别:

手术组

样本量:

20

Group:

Surgical group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

组别:

保守治疗组

样本量:

20

Group:

Conservative treatment group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

组别:

健康对照组

样本量:

20

Group:

Healthy control group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

山东 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

山东中医药大学第二附属医院 

单位级别:

三甲 

Institution
hospital:

The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

骨体积分数

指标类型:

主要指标

Outcome:

bone volume fraction, BV/TV

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

骨小梁厚度

指标类型:

主要指标

Outcome:

trabecula thickness,Tb.Th

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

骨小梁数量

指标类型:

主要指标

Outcome:

trabecula number, Tb.N

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

骨小梁间隙宽度

指标类型:

主要指标

Outcome:

trabecula Spacing, Tb.SP

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

2000国际膝部委员会(IKDC)主观膝部评估表

指标类型:

主要指标

Outcome:

2000 International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

Lysholm量表评分

指标类型:

主要指标

Outcome:

the score of Lysholm Scale

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

Oswestry功能障碍指数

指标类型:

主要指标

Outcome:

Oswestry Disability Index (ODI)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

膝关节损伤与骨关节炎评分

指标类型:

主要指标

Outcome:

Knee Injury and Osteoarthritis Outcome Score (KOOS)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

身高

指标类型:

次要指标

Outcome:

height

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

体重

指标类型:

次要指标

Outcome:

wright

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

半月板

组织:

Sample Name:

meniscus

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

脂肪组织

组织:

Sample Name:

synovial fluid

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

血液

组织:

Sample Name:

blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

骨头

组织:

Sample Name:

bone

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

软骨

组织:

Sample Name:

cartilage

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

滑膜组织及滑液

组织:

Sample Name:

Synovial tissue and synovial fluid

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

分组将采用计算机生成的随机化列表进行分层随机分组,由一名独立的统计学专家进行分配。

Randomization Procedure (please state who generates the random number sequence and by what method):

Grouping will be performed using a computer-generated randomization list for stratified randomization, with allocation conducted by an independent statistical expert.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Blinding:

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

None

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

本研究的数据采集和管理采用**纸质病例记录表(Case Record Form, CRF)与电子数据采集系统(Electronic Data Capture, EDC)相结合的方式,确保数据的完整性、准确性与可追溯性。 1. 病例记录表(CRF) 研究过程中所有原始数据将首先记录在标准化纸质CRF表格中; CRF内容包括:人口学信息、临床指标(BMI、BFP、WOMAC评分等)、实验室检测结果、步态运动学参数、干预依从性记录等; CRF由经过培训的研究人员填写,并由两人交叉核对以确保数据准确。 2. 电子采集与管理系统(EDC) 本研究采用ResMan临床试验注册与数据管理公共平台作为EDC系统; 所有CRF数据在核对无误后,将由专人录入EDC系统,系统设有自动逻辑检查功能以控制录入质量; 数据管理负责人定期备份数据,并设置访问权限以保障数据安全; 数据锁定前,所有数据将由研究团队进行统一核查与确认,确保其真实性与可用性。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

The Data collection and management of this study adopted a combination of paper Case Record forms (CRF) and Electronic Data Capture systems (EDC) to ensure the integrity, accuracy and traceability of the data. Case Record Form (CRF) All the original data during the research process will first be recorded in the standardized paper CRF form; The contents of CRF include: demographic information, clinical indicators (BMI, BFP, WOMAC score, etc.), laboratory test results, gait kinematic parameters, intervention compliance records, etc. The CRF was filled out by trained researchers and cross-checked by two people to ensure the accuracy of the data. 2. Electronic Acquisition and Management System (EDC) This study adopted the ResMan public platform for clinical trial registration and data management as the EDC system; After all CRF data are verified to be correct, they will be entered into the EDC system by a dedicated person. The system is equipped with an automatic logical check function to control the entry quality. The person in charge of data management regularly backs up data and sets access permissions to ensure data security. Before the data is locked, all data will be uniformly verified and confirmed by the research team to ensure their authenticity and availability.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2025-07-21 08:20:28