血清Omentin-1、Bax和RBP4在非创伤性股骨头坏死病情评估及诊断中的价值  

Value of serum Omentin-1,Bax,and RBP4 in the condition evaluation and diagnosis of femoral head necrosis

作　　者：王龙 王业华 冯骁 王海波 蒋健 袁泉 赵德勇 WANG Long;WANG Ye-Hua;FENG Xiao(Department of Orthopedics,Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221000,China)

机构地区：[1]徐州医科大学附属医院骨科,江苏徐州221000

出　　处：《临床和实验医学杂志》2023年第24期2617-2620,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省科技发展计划项目(编号:2020ZX01136)。

摘　　要：目的探讨血清网膜素(Omentin-1)、Bcl2-相关X蛋白(Bax)、视黄醇结合蛋白4(RBP4)在非创伤性股骨头坏死(NTONFH)病情评估及诊断中的价值。方法采用回顾性研究方法,选取2020年2月至2022年12月徐州医科大学附属医院经影像学检查确诊为NTONFH的患者100例作为病例组,另外选取100名健康体检志愿者作为对照组。检测对比两组患者血清Omentin-1、Bax和RBP4水平。并按照是否存在股骨头塌陷、国际骨循环研究会(ARCO)分期标准、患侧分布进行分层分析NTONFH患者血清Omentin-1、Bax和RBP4水平,确定其与患者病情的关系。通过受试者工作特征(ROC)曲线分析Omentin-1、Bax和RBP4诊断NTONFH的价值。结果病例组患者的血清Bax水平显著高于对照组,血清Omentin-1、RBP4水平均显著低于对照组,差异均有统计学意义(P<0.05)。股骨头塌陷患者的血清Bax水平显著高于非股骨头塌陷患者,Omentin-1、RBP4水平均显著低于非股骨头塌陷患者,差异均有统计学意义(P<0.05)。ARCOⅡ期、Ⅲ期、Ⅳ期患者的血清Bax水平逐渐升高,ARCOⅡ期、Ⅲ期、Ⅳ期患者的血清Omentin-1、RBP4水平逐渐降低,组间两两比较,差异均有统计学意义(P<0.05)。双侧股骨头坏死患者血清Bax水平显著高于单侧患者,血清Omentin-1、RBP4水平均显著低于单侧患者,差异均有统计学意义(P<0.05)。Omentin-1诊断股骨头坏死的敏感度为84.66%,特异度为77.20%,曲线下面积(AUC)值为0.872;Bax诊断股骨头坏死的敏感度为90.17%,特异度为83.75%,AUC值为0.780;RBP4诊断股骨头坏死的敏感度为70.57%,特异度为74.95%,AUC值为0.917。结论NTONFH患者Bax水平显著升高,Omentin-1、RBP4水平均显著降低,并且与患者股骨头塌陷与否、患侧分布、ARCO分期有关,在患者病情评估中具有重要参考价值。另外,Omentin-1、Bax、RBP4对NTONFH均有较好的诊断价值。Objective To explore the value of serum omentin(Omentin-1),Bcl-2-associated X protein(Bax),retinol binding protein 4(RBP4)in the condition evaluation and diagnosis of non traumatic necrosis of the femoral head(NTONFH).Methods A total of 100 patients diagnosed with NTONFH through imaging examinations in Affiliated Hospital of Xuzhou Medical University from February 2020 to December 2022 were retrospectively selected as the case group,and an additional 100 healthy volunteers were selected as the control group.The serum levels of Omentin-1,Bax,and RBP4 were measured and compared between the two groups of patients.And the levels of serum Omentin-1,Bax,and RBP4 in patients with non traumatic femoral head necrosis were stratified based on the presence of femoral collapse,the Association Research Circulation Osseous(ARCO)staging criteria,and its relationship with the patient's condition has been determined.The value of Omentin-1,Bax,and RBP4 in diagnosing NTONFH was analyzed using the receiver operator characteristic(ROC)curve.Results The level of serum Bax in the case group was significantly higher than that in the control group,while the levels of serum Omentin-1 and RBP4 in the case group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The level of serum Bax in patients with bilateral femoral head necrosis was significantly higher than that in patients with unilateral femoral head necrosis,and the levels of serum Omentin-1 and RBP4 in patients with bilateral femoral head necrosis were significantly lower than those in patients with unilateral femoral head necrosis,the differences were statistically significant(P<0.05).The levels of serum Bax gradually increased in ARCO stageⅡ,Ⅲ,andⅣpatients,while the levels of serum Omentin-1 and RBP4 gradually decreased in ARCO stageⅡ,Ⅲ,andⅣpatients,the differences between the two groups were statistically significant(P<0.05).The level of serum Bax in patients with bilateral femoral head necrosis were signif

关 键 词：Bcl2-相关X蛋白 视黄醇结合蛋白质类 诊断 网膜素 非创伤性股骨头坏死 

分 类 号：R681.8[医药卫生—骨科学]