非创伤性股骨头坏死血清SFRP5的表达及临床意义  

Expression and clinical significance of serum SFRP5 in nontraumatic osteonecrosis of the femoral head

作　　者：王琳 张蓉 栾婕 韦标方[2] WANG Lin;ZHANG Rong;LUAN Jie;WEI Bio-fang(The Second Clinical College,Binzhou Medical University,Yantai,Shandong 264003,China;People's Hospital of Linyi City,Linyi,Shandong 276003,China;Qingdao Central Hospital,Rehabilitation University,Qingdao,Shandong 266042,China)

机构地区：[1]滨州医学院第二临床医学院,山东烟台264003 [2]临沂市人民医院,山东临沂276003 [3]康复大学青岛市中心医院,山东青岛266042

出　　处：《中国矫形外科杂志》2025年第6期552-556,共5页Orthopedic Journal of China

基　　金：山东省科技攻关计划项目(编号:2014CSF119022);临沂市人民医院硕士研究生培养基金项目(编号:YJS202355)。

摘　　要：[目的]探讨分泌型卷曲相关蛋白-5(secreted frizzled-related proteins-5,SFRP5)在股骨头非创伤性坏死(nontraumatic femoral head necrosis,NONFH)中的意义。[方法]选取2023年9月—2024年1月在临沂市人民医院就诊的NONFH患者71例作为坏死组,选取同期性别、年龄与坏死组相匹配的68例健康体检者作为正常人组,采用酶联免疫吸附法检测两组受试者血清SFRP5浓度水平。比较两组间一般资料,坏死组按不同因素(ARCO分期、侧别、病因等)比较血清SFRP5浓度水平,并绘制检测ROC曲线,分析血清SFRP5对NONFH的诊断价值。[结果]坏死组血清SFRP5水平显著低于正常人组[(16.9±12.7)pg/mL vs(32.9±17.2)pg/mL,P<0.001]。坏死组中,股骨头塌陷患者血清SFRP5水平显著低于未塌陷患者(P<0.05),双侧坏死患者的血清SFRP5水平与单侧坏死患者的血清SFRP5水平差异无统计学意义(P>0.05),不同ARCO分期患者血清SFRP5水平的比较,随着分期的加重,血清SFRP5水平显著降低(P<0.05),差异有统计学意义(P<0.05)。两两相关分析方面,SFRP5水平与Harris评分呈正相关(P<0.05),与ARCO分期、VAS评分均呈显著负相关(P<0.05)。ROC分析中,血清SFRP5水平在诊断股骨头坏死塌陷时的敏感性为70.4%,特异性为80.9%,曲线下面积(area under curve,AUC)为0.787。[结论]随非创伤性股骨头坏死的进展,血清SFRP5水平呈下降趋势,SFRP5可能是诊断NONFH潜在的血清标志物。[Objective]To explore the role of secreted frizzled-related proteins 5(SFRP5)in non-traumatic osteonecrosis of the femoral head(NONFH).[Methods]A total of 71 patients who were diagnosed of NONFH in Linyi People's Hospital from September 2023 to January 2024 were selected as the necrosis group,while other 68 healthy persons who underwent regular health physical examination and were matched in gender and age with the necrosis group were selected as the normal group.Serum SFRP5 levels in the two groups were detected by ELISA.General data between the two groups were compared,while the serum SFRP5 in the necrotic group were compared according to different factors(ARCO stage,side,etiology,etc.),and ROC curve was drawn to analyze the diagnostic value of serum SFRP5 for NONFH.[Results]The necrotic group had significantly lower serum SFRP5 than the healthy group[(16.9±12.7)pg/mL vs(32.9±17.2)pg/mL,P<0.001].In the necrosis group,the SFRP5 was significantly lower in the patients who had femoral head collapse than those without collapse(P<0.05),whereas which was not statistically significant between the patients with bilateral necrosis and those with unilateral necrosis(P>0.05).However,the SFRP5 was significantly decreased with the increasing of the ARCO stages(P<0.05).In term of pairwise correlation analysis,SFRP5 was significantly positively correlated with Harris score(P<0.05),while significantly negatively correlated with ARCO stage and VAS score(P<0.05).In term of ROC analysis,the SFRP5 predicting NONFH was with sensitivity of 70.4%and specificity of 80.9%and area under curve(AUC)of 0.787.[Conclusion]Serum SFRP5 decreases with the progression of non-traumatic osteonecrosis of the femoral head,and SFRP5 may be a potential serum marker for the diagnosis of NONFH.

关 键 词：分泌型卷曲相关蛋白-5 非创伤性股骨头坏死 血清标志物 

分 类 号：R681.8[医药卫生—骨科学]